CALCULI IN THE KIDNEY 403 



severe. The condition may be entirely overlooked during 

 the life of the patient. The most pronounced symptoms are 

 sudden attacks of colic, which come on after running, jump- 

 ing, or falling, which dislodge the stone and occlude the 

 ureter. The colicky symptoms are howling, whining and 

 crying, which continue until the stone either passes into the 

 bladder or back into the pelvis of the kidney. A prolonga- 

 tion of the retention of urine may result in uremic symptoms. 

 Periodic recurrence of the colicky pains is somewhat charac- 

 teristic of this condition. The urine when examined micro- 

 scopically will be found to contain pus cells, epithelial cells, 

 and often very small fragments of stones. Blood cells are 

 also common as small hemorrhages frequently take place. 

 In the dog a direct examination can be made by performing 

 a laparotomy which permits of the kidney being seen and 

 felt. If calculi are present, they will be easily recognized by 

 their hardness and shape. 



Diagnosis. The general symptoms are not sufficient for 

 an accurate diagnosis. It should be differentiated from other 

 diseases of the kidney. The urine should be carefully exam- 

 ined. In doubtful cases a laparotomy may be performed. 



Prognosis. The prognosis depends on the size and number 

 of stones present and whether or not the condition is uni- or 

 bilateral. When the stones are small and the condition con- 

 fined to one kidney, the prognosis is much more favorable. 

 Owing to the difficulties encountered in removing the stones 

 the prognosis is usually unfavorable. 



Treatment. Dietetic. Food should be given that contains 

 but a small quantity of salts. Plenty of water should be 

 allowed but the same precaution must be observed in regard 

 to the salt content. 



Medical. The various compounds used to dissolve calculi 

 have not proved very satisfactory. Large quantities of 

 carbonated water may be tried; it has proved of value in 

 some cases. 



Surgical. Surgical treatment has proved of practical 

 importance in the dog, and has been successfully accom- 

 plished in a number of cases. If, after an explorative lapa- 

 rotomy of the kidney, it is found normal, showing no evidence 



