CHRONIC NEPHRITIS 395 



In parenchymatous nephritis the secondary symptoms 

 are characterized by dropsical swellings appearing on the 

 limbs, breast, and particularly ascites. The animal shows 

 general emaciation, pale membranes, and all the signs of 

 general cachexia. A careful examination must be made in 

 such cases to distinguish from circulatory disturbances. The 

 urine should always be carefully examined. We will find 

 in these cases the amount of urine decreased and its specific 

 gravity increased. The urine will also be found to contain 

 numerous casts, epithelium, fat cells, and in some cases red 

 blood corpuscles. The pulse will be found accelerated, tense 

 and hard; the heart beat is strong, palpitating, and in smaller 

 breeds may shake the entire body. Marked dulness over the 

 region of the heart is noted indicating hypertrophy. The 

 temperature is slightly elevated until in the later stages of 

 the disease when it will be found to be subnormal. In the 

 very late stages symptoms of uremia appear, with rapid 

 emaciation and exhaustion, and the animal soon succumbs. 



In chronic interstitial nephritis the symptoms are some- 

 what different. The most noticeable difference is in the 

 character and composition of the urine. The amount of 

 urine is increased, the specific gravity very low, and the 

 albumin content is greatly diminished. There is compensa- 

 tory hypertrophy of the heart, and if this compensating 

 action is sufficient, the animal may live for some time. How- 

 ever, sooner or later there will be insufficient heart action, 

 the pulse will become weak, feeble, and ascites and edemas 

 appear. The animal gradually becomes weaker and finally 

 dies from exhaustion. 



Diagnosis.— This is only possible in cases where a careful 

 examination is made of the urine, together with a pains- 

 taking general examination. We must differentiate chronic 

 nephritis from primary circulatory disturbances. 



Prognosis. —In both forms of chronic nephritis, the prog- 

 nosis should be considered unfavorable, because in the 

 majority of cases the condition is quite well advanced before 

 a diagnosis is made. Even in apparently mild cases marked 

 pathological changes in the kidneys are often found. 



