DEPARTMENT OF SURGERY. 
839 
usually causes renal colics, marked by painful attempts to 
micturate ( vesical tenesmus ). The urine during intervals of 
haemorrhage contains pus-corpuscles and tube casts. A correct 
diagnosis depends much upon the examination and analysis of 
the urine. 
Pain, as a symptom of malignant growths of the kidney or 
renal diseases, is not always of sufficient intensity to add much 
to the diagnosis ; but when it is severe it radiates from the kid¬ 
ney in the direction of the abdomen, loins, and extending to the 
thigh ; this is manifested by the position of the spine and the 
gait of the animal ; in renal diseases the lumbar vertebrae are 
usually curved ( lordosis ) ; no dependence can be placed in 
palpation to detect renal growths or diseases in herbiverous 
animals. 
Mortality. —Mortality varies according to the nature of the 
disease ; the highest percentage of mortality occurs in malig¬ 
nant disease of the kidney. In experimental surgery, nephrec¬ 
tomy is usually performed upon healthy animals and the result 
is generally very favorable. 
Operation. —The kidney can be removed in two ways, viz. : 
1. Lumbar nephrectomy. 
2. Celiomephrectomy. 
i. Lumbar nephrectomy is performed without opening the 
peritoneal cavity. The patient should be prepared for the op¬ 
eration ; properly cast, anaesthetized, and placed in the proper 
position. An incision is made posterior to the last rib in the 
direction of the ends of the transverse processes of the lumbar 
vertebrae. 
When the external border of the psoas muscle is reached 
the areolar tissue between it and the peritoneum should be 
broken down with the fingers until the kidney is reached. If 
the incision is not large enough it can be enlarged by making 
one or two secondary incisions ; the directions of these secondary 
incisions should be determined when the kidney is reached and 
its condition ascertained. If the organ to be removed is healthy 
the incision may not need to be enlarged, but if enlarged or 
adherent it may be necessary to make a number of secondary 
incisions to enable the operator to manipulate the kidney and 
ligate the vessels before it can be removed. These secondary 
incisions may be made in the direction of the external angle of 
the ilium and toward the posterior border of the last rib ; in 
small animals the costo-iliac space may be too small to admit 
• the hand if it is not enlarged in the direction of the external 
