1006 Chronic Indurative Nephritis. 



of clinical symptoms, it has usually already existed for months 

 and then is apt to continue for months or even years longer 

 during which time frequent variations are observed in the 

 intensity of the clinical picture. As has already been men- 

 tioned, certain forms of this nephritis, preferably in ruminants 

 and in hogs, run their course from beginning to end without 

 interfering with, the general health, and this may occasionally 

 be the case also in other species. 



Diagnosis. The existence of a chronic indurative nephritis 

 may be assumed properly if the quantity of the urine is in- 

 creased, the urine watery, the specific gravity low and when 

 the urine contains only small amounts of albumen and at most 

 few renal elements. These findings are often supplemented by 

 the demonstration of cardiac hypertrophy and by symptoms 

 of chronic uremia. The polyuria of active renal hyperemia 

 differs by a different history and by the constant absence of 

 albumen in the urine. Certain difficulties may be encountered 

 at most in the exclusion of that hyperemia which sometimes 

 persists for a considerable time after acute inflammations of 

 internal organs and which, on account of the simultaneous 

 degeneration of the kidneys or of a catarrh of the urinary 

 passages, is accompanied by slight albuminuria. In such cases 

 the condition of the circulatory organs and the manual ex- 

 amination of the kidneys must decide. — In diabetes insipidus 

 the urine is free from albumen, in diabetes mellitus it contains 

 sugar and its specific gravity is usually high. — ^In amyloid 

 kidney copious albuminuria is usual. Chronic non-indurative 

 nephritis may enter into the problem in the terminal stage 

 of atrophic kidney, when cardiac weakness is already present 

 and has caused the development of edema, while the specific 

 gravity of the urine is increased. But even in such cases the 

 presence of atrophy of the kidney may be decided upon on 

 account of the comparatively low content in albumen, the hyper- 

 trophy of the heart if present, and on account of the fact 

 that the specific gravity of the urine does not correspond to 

 the severe symptoms of urinary stasis. 



Prognosis. In clinically well-marked cases the disease ends • 

 eventually in death, which is, however, in many cases postponed 

 for years. 



Treatment. A regulation of the diet is indicated in so far 

 as the animals should be protected from all severe exertion 

 and receive good, non-irritating food (see p. 995). In cardiac 

 weakness heart remedies should be employed and an existing 

 edema may be counteracted by diuretic remedies. For anemia 

 the systematic administration of iron and of bitter remedies 

 is indicated in addition to good nutrition. 



