Diseases of the Urinary System including the Bladder

Diseases of the Urinary System including the Bladder

THESE ARE OF extremely common occurrence and are more frequently encountered in urban or built-up areas where the risk

of spread from contagious diseases such as Leptospirosis is always present. It is normal to find a degree of kidney failure

in the old dog, male animals being more disposed to this than females. The kidney conditions which concern us include

Interstitial Nephritis, which is encountered in both acute and chronic forms, Pyelonephritis, Nephrosis and Urolithiasis or

stone formation.

Other conditions less frequently met with are Hydronephrosis and Pyelitis. When we consider the bladder we find that

cystitis is fairly widespread in both sexes, possibly more so in the female. The end result of any of these conditions (except

cystitis) could be uraemia which can arise as a result of kidney failure when the kidney tissue is no longer capable of sepa-

rating waste products and toxins from the blood.

1. INTERSTITIAL NEPHRITIS

(a) Acute Form This is probably the commonest kidney condition met with in the dog.

ETIOLOGY. Acute interstitial nephritis is invariably bacterial or viral in origin, the commonest cause being infection due to

Leptospira species.

CLINICAL SIGNS. These can develop quite quickly and are at first accompanied by anorexia and depression. The patient

exhibits increased thirst while vomiting is a fairly constant feature. A rise in temperature is seen in the early stages but

may drop to near normal later. Signs of discomfort in the lumbar region are evident with tenderness over the kidney re-

gion and arching of the back. There is a disinclination to move and when the animal is encouraged to do so stiffness of

movement is seen. The coat becomes dry due to dehydration while circulatory disturbance is shown by a full bounding

pulse and discoloration of visible mucous membranes. Elimination of urine is decreased.

TREATMENT. There are many useful remedies employed in the treatment of this disease and these include the following

1. ACONITUM 12x. This should always be given in the early stages if at all possible. At this stage the animal shows anxiety

and distress and possibly fear. This remedy will do much to relieve the patient of these anxieties and help calm him.

2. APIS MEL 200c. This is a most valuable remedy considering that changes in the kidney tissue are accompanied by

oedema and swelling.

3. ARSEN. ALB. 1M. Indications for this remedy are the animals which show dehydration and harsh, dry coat accompanied

by thirst for small quantities of water. The mucous membranes of the eyes are red and there may be vomiting and diar-

rhoea. Symptoms are usually worse towards midnight when the patient becomes increasingly restless.

4. BELLADONNA 200c. When this remedy is indicated the animal will feel extremely hot, with dilated pupils and a full

bounding pulse. There are frequent attempts to pass urine which is scanty in amount and sometimes reddish-brown

in colour. Signs of central nervous system involvement may be present, such as excitability and possibly a tendency to

convulsions.

5. CANNABIS SATIVA 30c. There is a great desire to pass urine but little comes. The urine contains mucus and pus and

possibly blood. Passage of urine is accompanied by pain evidenced by the animal crying out.

6. CHIMAPHILLA UMBELLATA 30c. Again there is scanty urine which is dark and contains sediment. Frequent desire is also

present but symptoms are alleviated by the animal moving about

7. BERBERIS VULG. 30c. Arching of the back and tenderness over the renal area are very pronounced when this remedy is

to be considered. The animal prefers to stand and pains tend to move about over the whole lumbar area; all symptoms are

worse on movement. The urine itself may be clear but often it is of a yellow colour indicating the involvement of the liver

in the disease process.

8. TEREBINTHINAE 200c Symptoms of uneasiness disappear on movement. Frequent desire to urinate is present, the urine

containing blood and smelling sweetly like turpentine or violets.

9. PHOSPHORUS 200c. An important remedy which will help control vomiting which arises when liquids are rejected

shortly after ingestion. There may be an accompanying gingivitis with small haemorrhages present when this remedy is

indicated.

10. URTICA URENS 3x. This remedy helps elimination of waste products via the urine and promotes urination.

The patient, being dehydrated, should have free access to water. Remedies such as ARSEN. ALB. and PHOSPHORUS should

help control vomiting and also allow fluids to be retained. Homoeopathy has a decided advantage over conventional

medicine in this respect when fluids have to be given intravenously to maintain an electrolyte balance.

(b) Chronic Form. This is a progressive condition, varying degrees of which are found in the majority of dogs over eight

years old, although clinical signs may not be present in all cases. There is no one outstanding cause and while degenera-

tion of kidney tissue can follow the acute form and Leptospiral organisms are retained in the kidney it can also develop in

the absence of any obvious existing factor.

CLINICAL SIGNS. Progressive loss of weight occurs which is accompanied by stomatitis, vomiting and increased thirst.

The output of urine is increased, the urine itself being pale and watery. The specific gravity is low reflecting the retention

of solids in the animal's tissues. Dehydration is a constant feature, the coat being harsh and dry while the skin may show

scattered lesions of eczema.

TREATMENT. The following are the more prominent remedies to be considered:

1. ARSEN. ALB. 30c. The remedy to be considered when the patient shows excessive dehydration with increased thirst and

dry staring coat. Itching of various areas may be pronounced and all symptoms are generally worse towards midnight.

2 CHININUM SULPH. 6c. The amount of urine passed is excessive when this remedy is indicated. The urine is pale and

very watery, and may be strong-smelling. These symptoms are often accompanied by slight abdominal tympany which

produces increased respiration. Skin rashes may be prominent.

3. COLCHICUM 30c. Again there is increased urination with frequency. The urine can vary from clear to dark-brown. There

are usually accompanying joint pains indicated by stiffness and disinclination to move. Abdominal flatulence may be

more extreme than that exhibited under the preceding remedy, and in addition ascites may be present.

4. JODUM 30c. A suitable remedy for the older patient and for those animals which show wasting accompanied by raven-

ous appetite. The coat is dry and superficial lymph glands may show hardness while diminishing in size. There may be

frothy diarrhoea of a light creamy colour.

5. MERC. CORR. 30c. A useful remedy when the increase in urination is accompanied by straining with possibly mucous

diarrhoea as well. Symptoms are worse in the period from sunset to sunrise. It appears to have a beneficial effect on the

kidney tissue in general. Skin symptoms such as ulceration and red eczematous patches are frequently present.

6. PHOSPHORUS 30c. This remedy also has a beneficial or tonic effect on the kidney parenchyma. Output of urine is also

increased and vomiting of stomach contents when they become warm is a strong guiding symptom for its use.

7. PLUMBUM MET. 30c. This remedy may be indicated in those conditions where excessive wasting over the lumbar region

is accompanied by a tendency to paraplegia or weakness of the hind quarters. Other signs of incipient paralysis may arise

such as difficulty in retaining saliva. Extreme constipation is invariably present.

8. NATRUM MUR 30c. Excessive urination and frequency is a notable feature when this remedy may be needed, and this is

often worse during the night. Mouth lesions in the form of superficial ulcers and blisters are often present while hawking

and scraping of throat occurs.

2. PYELONEPHRITIS

This occurs more commonly in bitches and is frequently a sequel to cystitis and sometimes co-exists with it. It can arise

when there is any obstruction to the passage of urine and leads to the presence of blood and pus in the urine. A specific

bacterial cause is Corynebacteria renale, an organism which lodges in the kidney pelvis leading to the formation of purulent exudate. A secondary cystitis usually co-exists in this instance. Diagnosis is by the presence of purulent material and

blood in the urine. The following remedies may help in cases not too far advanced:

1. HEPAR SULPH 30c. This is one of the main remedies in combating pyogenic infections and treatment may have to be

continued through various potencies to achieve results.

2. SILICEA 30c. Long-standing cases may respond to this remedy given over a period of two months giving a dose twice

weekly.

3. MERC. CORR. 30c. Accompanying symptoms of slimy diarrhoea, salivation and skin ulceration may determine the use of

this remedy. The urine frequently has a greenish tinge because of dissolved (characteristic) pus.

4. PAREIRA 6c. Severe straining with discharge of mucus from the urethra may indicate this remedy. There is extreme

tenderness over the kidney region. The urine frequently smells strongly and there is severe difficulty in passing it, the an-

imal assuming a pronounced crouching attitude.

5. UVA URSI 6c. With this remedy the urine is exceedingly slimy and contains whole blood and possesses a greenish tinge

Straining is again evident.

FOOTNOTE. It might be difficult for the owner or attendant to differentiate between these various remedies and in practice

it may be necessary to try a different remedy if the most likely one fails to relieve. It should be possible to achieve relief of

the condition from one or other of the above

3. NEPHROSES

This is the term used to describe the degeneration and consequent necrosis of the secreting tubules of the kidney and

their obstruction on account of various deposits within them.

ETIOLOGY. Various poisons and toxins are usually implicated, chief among which are chemical agents and secondary

products from infected wounds or burns.

CLINICAL SIGNS. In the early stages there is marked diminuation of urine output and in severe cases when the secreting

tubules are blocked with crystalline casts there may be a complete suppression of urination. The initial stage is shortly re-

placed by increased output of urine which shows blood cells and albumen casts.

Diagnosis of this condition depends very much on laboratory urine examination when specific gravity readings and

other tests will reveal the exact nature of the problem.

TREATMENT. We have to rely mainly on remedies which have an action on the kidney parenchyma and have in addition

the reputation of being good constitutional remedies. Chief among these are the following

1. PLUMBUM MET. 30c. This metal in the crude state has a destructive action on kidney tissue and we should therefore

expect it to have a beneficial effect in preventing further degeneration when used in potency. There may be an accompa-

nying paraplegic tendency when it is indicated with the possibly peripheral nerve involvement as well.

2. PHOSPHORUS 30c. This element also has a necrotic and destructive effect on tissue such as kidney and liver, producing

necrosis with accompanying constitutional signs such as vomiting and superficial haemorrhages.

3. SILICEA 30c. This remedy possesses the power of absorbing scar tissue which we would expect to be present in the

kidney parenchyma when we consider the nature of the disease we are discussing. It could be of particular benefit to the

naturally lean animal

4. SOLIDAGO 6c. This is a useful remedy in the early dysuric stage, when the urine contains a thick sediment and is dark

brownish-red in colour. The sediment may show a heavy phosphate content, and diarrhoea and/or dysentery may be

present as well

5. THUJA 6c. This is a good constitutional remedy in general. The urine is possibly frothy with cloudy sediment. The ani-

mal shows signs of pain by kicking or licking in the region of the bladder and the urine frequently dribbles away after the

main stream has been passed.

6. ARSEN ALB. 30c. Also a good constitutional remedy for the patient which shows dehydrated coat with diarrhoea, skin

irritation and periodic vomiting. Symptoms are always worse towards midnight when the animal becomes increasingly

restless and drinks frequently.

7. MERC. CORR. 6c Animals with dry eczematous or ulcerated skins showing in addition slimy saliva and mucous diar-

rhoea may need this remedy. It has a marked action on the kidney parenchyma and is useful in higher potencies as well as

lower.

8. URTICA URENS 3x. A useful remedy in the early dysuric stage when it may help produce diuresis. There is frequently

an accompanying oedema of body tissues especially along the abdomen and chest. It possesses the ability of eliminating

gravelly deposit from the tissues and produces a thick turbid urine.

4. UROLITHIASIS. Stone or Calculi Formation

This is a constitutional problem which has as its end product the formation and subsequent deposit in the renal pelvis and

bladder of sabulous or gravel material which coalesces into stones or calculi. They are most commonly encountered in the

bladder and occur more frequently in male animals.

ETIOLOGY OF CALCULUS FORMATION. Calculi which are predominantly made up of phosphates usually have their origin

in an alkaline urine which can predispose to urinary infection. These are the most commonly encountered, others such as

cystine or urate calculi occurring less frequently and more often in particular breeds because of genetic defects.

CLINICAL SIGNS. The first signs observed are usually the passage of blood and the presence of purulent material in the

urine. Depending on the degree or advancement of stone formation there may be passage of thickened urine showing

heavy deposits or more frank difficulty in passing urine. Pain in the bladder may cause the animal to cry out and lick or

gnaw at the bladder area. Severe pain and discomfort attend the passage of urine which is usually voided drop by drop.

TREATMENT. Once large stones have formed the only rational treatment is surgical, but in the early stages when the

sabulous material has not coalesced into calculi there are a number of useful remedies available which will prevent fur-

ther deterioration and in some cases dissolve the gravelly material itself. Chief among these are the following

1. LYCOPODIUM 30c. This remedy has a tonic action on the liver and will help control the metabolism of that gland, mal-

function of which is frequently the cause of the tendency to gravel formation. Subjects which require it are frequently thin

and wizened-looking showing reddish discoloration of urine on standing.

2. BERBERIS VULG. 6c. This remedy also acts in much the same way. Indications for its use include tenderness over the

lumbar region with yellowish discoloration of urine.

3. HYDRANGEA 3x. This is an important remedy which helps both prevent calculi if given as a routine and also aids in

the dissolution of sandy material making it easier to eliminate. The urine may contain white salts alternating with yellow

sandy material.

4. EPIGEA REPENS 3x. Urinary deposits are of the uric acid type when this remedy is indicated. They take the form of a

brownish deposit. There is much straining when attempting urination.

5. BENZOICUM ACIDUM 6c. This also has uric acid deposits in its provings but it differs from the previous remedy in giving

the urine a disagreeable heavy odour. Catarrhal mucous sediment occurs.

6. THLASPI BURSALIS 6c. Phosphates are in abundance when this remedy is needed. It will quickly dissolve sabulous ma-

terial and produce an increase in deposits of a brick-red colour when used in potency.

7. URTICA URENS. 3x. This remedy also thickens the urine and removes the tendency to gravel formation by removing the

basic salts which help form it. It will also increase the quantity of urine passed.

8. CALC. PHOS. 30c. A good constitutional remedy which will regulate the Ca. and P. metabolism and so prevent the forma-

tion of phosphates. It should be given as a routine remedy in young animals up to the age of one year.

9. MAG. MUR 6c. This remedy may have a part to play in preventing the formation of some forms of calculi and may be

given like CALC PHOS, as a routine remedy if the urine shows suspicious deposits and other signs of urolithiasis. It should

thus be helpful in controlling the tendency to form more stones.

10. LITHIUM CARB. 6c. This remedy shows turbid urine containing a significant amount of mucus with dark-brown de-

posits. It aids liver function and helps control the tendency to manufacture more lithates.

11. OCIMUM CANUM 6c. This remedy is useful once gravel has formed. The urine is a bright-yellow colour with a musky

odour. The sediment is brick-red in colour.

FOOTNOTE As phosphates are the principal salts concerned in the formation of calculi in the dog, a diet which is on the

acid side of ph will be of considerable help in preventing stone formation. This can be ensured by adding a teaspoonful of

apple cider vinegar to the animal's food or drinking water daily. The dog may at first object to the taste but will soon adapt

if the practice is persevered with.

5. CYSTITIS. Inflammation of the Urinary Bladder

This is a frequently-encountered problem which can affect dogs and bitches of all breeds.

ETIOLOGY. The cause is usually bacterial in the acute form but a significant number of cases may also be due to mechan-

ical causes such as damage to the bladder lining due to the presence of calculi giving rise to a more chronic form. Strepto-

cocci, Staphylococci and forms of E. Coli are bacteria which have been implicated.

CLINICAL SIGNS. The principal sign is frequency of urination which is often attended by severe straining, the urine being

voided drop by drop and usually containing blood. Constitutional upset is evidenced by fever with occasionally vomiting

and diarrhoea. The animal resents pressure over the bladder region and the urine may be strong smelling and is usually

dark in colour.

TREATMENT. The homoeopathic practitioner or attendant is fortunate in having at his disposal a plentiful supply of well

proven remedies for the relief of this condition. Chief among these are the following:

1. ACONITUM 12x. Will be of value in the early feverish phase of the acute stage, helping to calm the patient and allay pain

and fear.

2. CANTHARIS 6c. One of the principal remedies employed. The patient strains violently and passes blood-stained urine

drop by drop, with great frequency.

3. CHIMAPHILIA UMBELLATA 6c Straining is again evident with this remedy but the urine passed contains more purulent

material than blood. The urine is often dark-green and extremely strong. The patient appears to obtain relief by moving

about.

4. COPAIVA 6c. The urine possesses a sweetish smell and has a frothy appearance. In the male animal there may be bal-

anitis with attendant itching causing the animal to lick frequently at the affected parts. Frequent urging is also present.

5. CAMPHORA 6c. Urine is voided slowly and is of a yellow-green colour. On standing there occurs a reddish sediment.

There may be retention of urine with ineffectual attempts at micturition.

6. EQUISETUM 6x Frequent urination occurs but is not usually associated with straining. Passage of urine does not relieve

symptoms of discomfort. Tenderness over bladder region extends towards the lower right flank. Frequency of urination is

worse during the night.

7. EUPATORIUM PURPUREA 6c. A remedy which may relieve the more chronic form of cystitis due to the presence of calculi

which leads to passage of a few drops of urine at a time. If such obstruction is removed by passing the stone, large quanti-

ties of urine may be passed, especially at night, the urine containing a high albumen content.

8. PAREIRA 6c. A useful remedy for the more chronic form in which the musculature of the bladder has probably become

thickened and without tone. Urine continues to dribble away after the main stream has been passed. There is an odour of

heavily contaminated with mucus

ammonia from the urine which

9. CAUSTICUM 30c. A useful remedy in the recurrent or chronic form and is especially adapted to the older animal. It fol-

lows well after CANTHARIS which may be needed if acute symptoms develop during a flare-up in the chronic form.

10. SABAL SERRULATA 6c. A useful remedy more adapted to bitches than dogs as frequently there are accompanying ovarian or uterine symptoms. Tenesmus is present along with a glutinous mucus at the urethral meatus.

11 TEREBINTHINAE 200c. Indications for this remedy include the presence of much blood in a scanty amount of urine.

There is a sweetish smell from the urine resembling turpentine or violets. Symptoms of discomfort are eased by move-

ment

12. UVA URSI 6c. Signs of pain or discomfort over the entire pubic area accompany the passage of greenish slimy urine

containing blood and purulent material. There is straining and frequent attempts at passing urine which do not relieve

symptoms of pain.