278 THE DOG m DISEASE. 



itself {nephritis)^ of the bladder {cystitis), or from renal 

 or cystic calculi. 



As these are not very common affections, a general 

 account, so as to enable a differential diagnosis to be 

 made, will suffice. 



The history of the case is important, and in all in- 

 stances a careful physical examination should be made, 

 to establish local tenderness if present, bladder disten- 

 tion, etc. 



Tenderness over the loins when rheumatism can be ex- 

 cluded points to the kidney ; tenderness abov^e the pubes 

 (between the thighs) to the bladder. 



Ordinarily, percussion does not discover the dullness of 

 the bladder, but on distention it should, while at the same 

 time the hand may be able to make out a somewhat globu- 

 lar tumor. 



Differential Diagnosis. — In acute nephritis the kid- 

 neys are swollen, and there may be escape of an albumin- 

 ous fluid from the vessels, and of red blood-cells as well as 

 leucocytes ; hence albuminous urine, bloody urine, tender- 

 ness over the loins, with febrile symptoms, suggest acute 

 nephritis. 



Blood makes the urine " smoky " or brown in appear- 

 ance. Blood may be positively diagnosticated by the 

 microscope, or, better, with the spectroscope. 



In Acute Cystitis, tenderness over the loins is not so 

 likely to exist, though j)ain may radiate in various direc- 

 tions, and tenderness over the bladder is nearly always 

 present. The urine is not so likely to contain blood, but 

 the urine may be turbid, alkaline, or contain excess of 

 mucus, which is not to be mistaken for albumin, which 



