Seeing WitchyThings
A Paranormal Women’s Fiction Novel
Roxie’s Midlife Adventures book 2
LeighRaventhorne
The characters and circumstances in this story are a product of the author’s imagination, and represent no real person, living, dead, nor undead. Any real public places or names are used only to build atmosphere for the reader’s mind.
Copyright © 2020
Leigh Raventhorne
All Rights Reserved
No part of this story may be reproduced in any way without prior written consent of the author.
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 1
“How is all of this going to work?” Rand motioned back toward the house. “Toby and I here, that is. He’s my . . . anchor I guess you could say. Wherever he is, I need to be too, most of the time. Short periods away I can do, but that’s it. Are you sure Sam will let us stay?”
“We’ll make it work however we need to. You’re a gentleman, I know that. And, if it’s anything like it was with Elmer, you’ll be off in your gray space or wherever, for the most part, right?” I asked, finally looking over at him. Neither of us were ready to address that kiss, so we both seemed to be pretending it never happened. Plus, I’m pretty sure my face was still blotchy from crying earlier, after Elmer crossed over. Lucky for me it usually took a lot to bring me to tears, because I was nota pretty cryer.
He shrugged. “I can be, but remember—Elmer was a lot older than me, in both ways. He also felt a strong pull to cross the whole time he was on this side, which would have cost him some of his energy. That and he was mainly here for the sake of passing along his family’s jewelry and stuff. Jake was only a secondary reason, not an anchor. I’m not entirely sure about how all of this works, truthfully. Some of it I’m just guessing based on my own experiences, but I think having a strong anchor matters to whether we are able to stick around, somehow. Age doesn’t always equate to strength in my world, but in my case I think it helps. I may be newer
as a spirit, but I’m younger, have Toby, and I don’t really have anything pulling me to the other side.”
Digesting that for a moment, my eyes scanned the yard for Jake. I felt so bad for him. I already missed Elmer so I knew he had to be missing him more–he had disappeared not long after Elmer had crossed. He wouldn’t just cross on his own now, would he? From what Rand was saying, Elmer would have been Jake’s anchor. Immediately worried, I asked Rand about that.
“I can still sense him a little bit. I don’t think he’s gone, just recovering, most likely. And you’re right, Elmer was Jake’s anchor. But, I think he’s bonded pretty well to Toby over the last week and he’s protective enough over you—that he might be able to stick around for a bit. He’s been on this side for so many years now, that the pull to cross has probably lost some of its appeal. I’m thinking,” he paused, looking away, “maybe the things that hold us here aren’t set in stone. Maybe our anchors can be, I don’t know, transferred, if we lose them?”
Every answer I received, just added to my list of questions. The garage door opening heralded Sam’s arrival home. That she was going to be surprised by everything I had to tell her, not to mention the new addition to the household, was a huge understatement.
I stood and called Toby over to me. I had already gone to the nearest pet store and picked up everything Rand had recommended. My tear-stained face had earned me a few looks, which I explained away as happy tears over getting my new dog. Now it was all up to how Sam reacted. Rand stood on the other side of the German Shepherd, looking nervous.
“When she starts to approach, tell Toby she’s a friend,” he instructed. “He’ll accept her as someone who’s allowed to be here, that way.”
What the heck kind of training had this dog had? There was no time to ask Rand more about any of that now. I saw Sam moving through the kitchen now, setting her attaché on the counter, and looking around with a puzzled expression on her face. Waving to get her attention, I motioned for her to come outside. She froze when she saw the big dog sitting attentively next to me, watching her every move.
"Toby. Friend.” This had better work or we would all be looking for new accomodations soon. Well, I guess Toby and I would, anyway. It’s not like Rand and Jake needed a bed or a roof over their heads.
Sam slowly slid the sliding door open, watching Toby warily as she stepped out. “Dare I ask why you have a dog that looks like he belongs to the local police force in my backyard? I’m guessing there’s a story here and you didn’t just go out and buy it, right?”
“Tell Toby ‘Let’s meet Sam’. Tell him again that she’s a friend.” Rand murmured to me, though there was no way Sam would have been able to hear him anyway.
“It’s, I mean he’s, well, Toby’s a boy,” I stammered out. “Come on Toby, let’s go meet Sam. She’s a friend.”
I walked over to Sam, who stood motionless, eyeing the dog as if he was going to attack. Toby trotted next to me obediently, only looking back at Rand once. Stopping in front of her, he reached out
his paw and laid it lightly on her shoe with a soft ‘woof’, looking up at her expectantly.
“I think that means ‘Hi’ in dogspeak.” I laughed and knelt down next to him, scratching his ears. “He’s a good boy and listens really well.” I peered up at her and asked in my best mock begging voice, “Can we keep him? Please?”
Sam slowly sat down in the patio chair next to the door. “He’s gorgeous,” she said to me. Then to Toby, “Hey there, what’s your story?”
She gently scratched his ears and neck. His eyelids drooped and his tongue lolled out, tail wagging lightly against the deck. He loved the attention. Rand chuckled behind me. For a second, I thought I heard him say ‘ham’ under his breath..
“It’s, um, quite the story. Want to hear it out here or inside?”
“I think inside might be best. Will he be okay out here on his own?” she asked.
Trying not to laugh, I cleared my throat before answering her. “Yes, he’s good. He’s got a water bowl at the bottom of the steps and there’s plenty of shade. I’m just glad your yard is fenced.”
As we walked inside, Rand called Toby away from us. It was hard for me not to look back at him as we stepped inside.
“No. He. Didn’t!” Sam exclaimed, shaking her head after listening to me recount the episode in the park with Steven for the second time. “He’s even more stupid than I thought he was. Now he’s right back in jail!”
“Yes, he totally did and yes, he is, on both those counts. Sam, are you sure you’re okay with Toby being here?” I was more worried about bringing the big German Shepherd home with me than I was about my ex-husband. I was her houseguest, after all.
“He’s fine. So long as he’s housebroken and he lets me in the house, we’re good. You’re sure the woman who abandoned him won’t come back looking for him?” she asked, considering the big dog currently exploring the backyard with Rand—whom she couldn’t see, of course. Toby had been such a perfect gentleman when I introduced him to her, that I think she was actually impressed.
“Oh, I’m pretty sure. There were lots of witnesses who saw her run off and leave him. She left him alone there on a regular basis too, I guess, while she ran errands and . . . stuff.”
Sam shrugged. “Then I think you have yourself a dog.”
I bit my lip, thinking. Should I tell her about . . . everything else? Yes, it was time. Past time, actually. Just rip the band-aid off, right? Taking a deep breath, I started, “Sam, we need to talk. There’s something else I really need to tell you.”
“Of course, what—”, she cut off as her cell phone rang. She smiled when she looked at the caller I.D. “It’s Leo, do you mind if I take this and we can continue in a few minutes?”
“Uh, sure. Go ahead.”
She walked into the study as she answered the phone. I was happy to see my best friend—who was my former boss as well as my divorce attorney—so excited over a relationship. Her success and her confidence tended to scare most men off. The ones that weren’t,
usually couldn’t pass her background check. She had extremely rigid standards.
Rand popped in at that moment, making me jump. “Well?”
He looked as nervous as a new mother. I smiled. “She’s good. She said he can stay. I told you she would be fine with him.” I laughed. “I think he might like her better than he likes me.”
He let out a relieved breath, his whole body relaxing. “I know you said she would. It’s just . . . Toby means a lot to me. It’s been really hard for me to see him treated the way he was, living the way he had to with that woman for so long.” He shook his head, dispelling his grim look at that memory. With a roguish grin he went on. “And he’s always been a complete ham with all the ladies. In fact, when I was alive, er, nevermind.” I didn’t realize a ghost, or spirit as he called himself, could blush.
I raised a brow at him. “Really?”
Sam walked back in at that moment and looked around the room, confused. “Who are you talking to?”
Rand popped out faster than he had popped in. I watched as he reappeared outside, next to Toby, who had finished exploring and was now marking every bush and shrub in the yard for the second or third time.
“Yeah, about that . . .” This was not going to be an easy conversation. “I’ve been, um, experiencing some things since I got out of the hospital.”
“Well, you’ve been through a lot. That’s not unexpected. You should have said something sooner! Do you need to talk to someone about it? I’m sure Leo can recommend somebody.”
“No, no, it’s not like that, Sam. It’s, um . . .” Crap. How did you tell your friend you could see things that she couldn’t? Ghost things. “I can kind of see things now. I can see people that are dead. Um, dead people.”
She was completely silent for about five seconds. “Okay,” she said slowly. “Are we talking Bruce Willis kind of dead people or zombies kind of dead people?”
“Um, the Bruce Willis kind?” I did notmean for that to sound like a question, but that’s how it came out. Seriously,Roxanne.Growa pairalready!“It’s kind of a long story. And there’s more. Can we go sit down or something? I really need a cup of coffee for this.”
“Sure, Rox.” Sam followed me into the kitchen. I could see the concern on her face. She thought I was losing it. Heck, she probably thought I had already lost it. “Are you sure Toby is okay on his own outside? He’s been out there by himself for a while now.”
I sighed. How did you go about telling your best friend, who you were also living with, that the dog you just brought home wasn’t exactly alone out back? He had the ghost of his former owner keeping an eye on him. Yeah, it’s all good. “He’s fine. He’s still exploring.”
We sat down after pouring our coffees, Sam watching me carefully. Waiting for . . . what? Me to crack? Go nuts?
Crap.Ishouldhavepreparedbetterforthis.
I looked up at the ceiling, asking the Powers That Be, as my mother used to call whomever was up there, for the strength to get through this conversation. I could do this.
I started at the beginning. My second day home from the hospital, meeting Elmer, the jewelry . . . and just let it all roll out. It took a little while and, to her credit, Sam didn’t interrupt me a single time. I ended with Steven attacking me at the park and Jake, Toby, and Rand coming to my rescue. I omitted Rand kissing me. I wasn’t even ready to address that with myself.
When I finished, I could see her working through all of it in her head. I chewed my lip nervously. She opened her mouth to speak, but quickly shut it again. I saw her glance at her phone and my heart dropped. She didn’t believe me! Was she going to call Leo after all, thinking that maybe I needed a nice vacation in a posh institution, making macaroni necklaces and finger painting landscapes? Crap.
“Just a second Sam, bear with me here.” I jumped up and hurried out to the back deck. Rand heard the sliding glass door and appeared beside me, instantly. Toby ran over goodnaturedly, panting happily. “Rand, can you, um, appear for Sam?”
He frowned, instantly worried. “What’s going on?”
“I, um, kind of decided to tell Sam, you know—everything,” I said, chewing my thumbnail. I snatched it back from my mouth, once I realized what I was doing. That used to be a nervous habit I had stopped years ago. “It might be easier if she could just see you, even if just for a minute.”
“After everything today . . . it’s going to take me a little while to recover some of that energy. Even then, I’m not sure if someone without your Sight would be able to see me.”
Ohno,Iknewthat!“Is there anything you can do? After everything I just dumped on her, there’s no way she’ll believe me without some sort of proof. That’s just how her mind works.” It used to be how mine did, too.
He appeared to be thinking. “I don’t know how much I can affect the living world right now, but let me try something. Go back inside. Is it okay if Toby comes in?”
“Yes, of course he can. Come on, Toby.” The big dog came in and heeled beside me as I walked back to the sitting area. When I sat, he sat also, looking like he was at attention. Sam somehow managed to look both impressed with Toby and worried about me at the same time.
“You have to release him. He won’t budge from your side until you do,” Rand supplied helpfully. “Just look at him and say ‘free’.”
“Oh, okay. Toby, free.” Toby immediately walked over to Sam and nudged her hand to pet him. Sam was still watching me, but she pet Toby’s head absently. I wondered why he hadn’t been this way with Cruella. She hadn’t known any of his commands, had she? I would have to remember to ask Rand about that later.
“Roxanne, what was . . . all that about?” Sam asked cautiously. She was using my formal name. That wasn’t good.
“Rand was telling me Toby wouldn’t move until I gave him his release command.”
Sam’s eyes slowly scanned the area around me, then around the room. “And, this Rand, is he here now?”
“He’s standing right beside my chair.” I held out a hand to indicate where he was standing, without bothering to look. My fingers
brushed into his space, I guess, and I pulled them back quickly, hissing at the instant cold. “Crap!”
Sam just continued to watch, looking more worried by the second.
An idea occurred to me. “Rand? If Sam does what I just did, will she feel the cold too?” I asked hopefully.
“I think she would feel it some, but I’m not sure if it would be to the extent you do. Since you’re . . . sensitive, I guess, to spirits, it’s possible you would feel it more than a regular person.” He looked thoughtful. “But I might be able to boost that a bit.”
“Let’s try.” I turned back to Sam. “This is about as much energy as he can expend right now, after the park this morning.” I glanced at him and nodded toward her. “He’s going to try to touch you. It should feel cold. Maybe just hold out your hand for him or something?”
She looked to the side of me again, where Rand had been, not realizing he’d moved and was standing beside her now. She tentatively held her hand out.
Rand’s brow furrowed as he concentrated. Most of his body faded a bit as he lightly touched her hand. Sam sucked in a breath and snatched her hand back, rubbing at it with her other hand.
Yes!I wanted to jump up and raise a hand in victory. If I wasn’t so sore from my encounter with Steven earlier in the day, I might have attempted it.
“Oh my god, Roxie! This can’t be real.” Sam’s voice quivered a bit.
“I know it’s a lot to take in. Believe me, I know. I’ve been living it for the past few weeks.” I laughed, tearing up with relief. “I kept trying to figure out how to tell you without you sending me back to the hospital for more brain scans. I’m still not sure I believe all of it.” I gave a half laugh. “I was scared I was still in a coma or something for the first few days.”
I reached over and grabbed her hand. This was huge. I didn’t think there was any way she would have believed me.
Rand stepped away from her, looking even more faint around the edges. Sam’s eyes rounded as she looked right to where he was now standing. She sat back, her hand pulling from mine.
“Where’d he go?” she asked, looking all around.
“What are you talking about?”
“The man that was just standing over there. Was that your ghost?” Her face had gone a full shade paler, but her voice was steady, at least.
“You could see him?” I turned to Rand, incredulous. “What did you do? Can you do it again?”
He shook his head, hands up. “It wasn’t me. I’m nearly wiped out.”
Sam watched, well, my part of the exchange, I guess. She looked at my hand and then back toward where Rand was standing. “Roxie, give me your hand.”
Reaching over to her, I did as she requested. As soon as her hand closed around mine, she gasped. “I see him! But, his features are kind of blurry.”
“Can you hear me, ma’am?” Rand asked.
Sam didn’t react, so that was a no-go. “If she hears you call her ma’am, she’ll probably kick you right back into your gray space, Rand.”
“What did he say? And why can you see and hear him but I can only see him?”
I repeated what he had asked. Thinking about her second question, I looked down at my hand. The Power Ring. Was that allowing Sam to see, or kind of see, what I could? I pulled my hand back and took the ring off.
“Here, try this on and see what happens.”
To her credit, she only hesitated a moment before sliding it on. It was big on her slender finger. She looked back toward Rand, then back at me, shaking her head. “Nothing. Can you still see him?”
I started to frown, barely catching myself. It was another habit I was trying to break. No frowning, no wrinkles, right? “Yes, he’s still right where he was a moment ago.” So it wasn’t the ring. Was it me?
Sam slid the ring back off and set it on the small table between us. She reached out and took my hand in hers again. “I can kind of see something there, but not like before. What if you put the ring back on?”
As soon as the ring was back on, Sam’s hand back in mine, she could see him again. My mind was spinning by now so I could imagine what was going through her head. At least I’d had some time to adjust by now.
I leaned back, gently taking my hand back from hers.
“You’ve been living with this, all by yourself now, for weeks, Roxie?”
I just nodded. After everything that had happened today, I was almost at the end of my emotional limit.
“What were you thinking? How could you not tell me any of this? How could you not tell me I have ghosts living in my house, Roxanne?” She was using my formal name again, which meant she was genuinely upset.
“Think about it, Sam. I didn’t have any way to prove any of it. Just fifteen minutes ago, you were ready to call Leo and find out where the nearest five-star institution was,” I said quietly. By her guilty expression, I knew it was true. “I tried to figure out a way almost every day to tell you, I really did. And Elmer is gone now, so you really only have a ghost dog and Rand, if you say he can stay.”
She was speechless, I think. I sat back and closed my eyes, letting her work through all of it in her head.
“I–” she started. Clearing her throat, she tried again. “I need to think about it. This is a lot to take in. That a whole other world exists all around us that we don’t even know about. Ghosts, ghost dogs, crossing over, magick jewelry? It all sounds . . .”
“Crazy?” I sighed out, suddenly exhausted. “Yeah, it does.”
Opening my eyes, I looked over at Rand. He had looked worried before, but now he looked even more so, if that was possible.
Sam must have noticed how tired I was. I knew she saw me look over at Rand, even though she couldn’t see him any more.
“What if . . . ” she began thoughtfully, “what if we give it a trial run. No pun intended.” Ah, lawyer jokes. This was a good thing. “How about we give it a couple of weeks and see how we all–adapt, I guess, and go from there?”
“Only if you’re sure. If it makes you uncomfortable, I’ll start looking around for a house.” Too bad Sam couldn’t see the relief on Rand’s face.
She shrugged a shoulder. “I’ve had ghosts for this long, apparently. What difference will a little longer make? If I’d known, I probably would have been charging them rent.” She laughed wryly. “Besides, I already told you, I like having you here.”
We both chuckled at that. Which reminded me . . .
“Have you ever been up in your attic?”
“No, I never really needed the space for anything, I guess. Why?”
“Elmer’s family left a lot of things behind after he passed. He doesn’t know why they didn’t want any of it. He said it’s yours now, technically. I, uh, I snooped through some of it on my own after Elmer showed me it was there. Some of the things are valuable, I think. There’s depression glass, pyrex, books, oh, and Elmer wanted you to have the handmade quilt in his memory chest.”
“That was . . . thoughtful of him.” Toby, who had been patiently sitting at her side through all of this, nudged her hand to pet him again. She obliged, without even looking at him. “Maybe we’ll take a day over the weekend and go through it. I don’t have any need for the glassware but I would like to take a look at the books.”
“Oh, I didn’t make anything for dinner with, you know, everything going on. Sorry.” I hadn’t even thought about dinner. I didn’t think I
would be up to eating tonight anyway. “If you don’t mind, I think I need to turn in early tonight. It’s been a really long day.”
“No problem, Rox. I’m still trying to absorb all of this. There’s enough in the fridge, I can just put something easy together. Go to bed and we’ll figure this out tomorrow.” She paused. “What about your birthday this weekend?”
She’d told me last week that she wanted to have a party for me. It was going to be a combined divorce/birthday party. Was I up for that?
“Let me think about it. Maybe we can just do something on a smaller scale. You’re sure you’re good on your own for dinner?”
She nodded, already lost in thought, still petting Toby whose eyes were half closed, he was so relaxed. I noticed he was leaning against her leg and her slacks were already covered in dog hair. Yeah, that might be a problem. Annie, Sam’s housekeeper and friend to us both, was going to have something to say about that I was sure. If only that were the least of my worries.
“I’m heading up to bed, then. Come on, Toby.” He stood up as I did, grumbling a little.
“I’m okay with him, if you want. He’ll need to go back out again, anyway, right?”
Surprised, I agreed. Huh. Looks like Sam had taken quite a liking to Toby. “Sure. I’ll leave the door open and he can come in when you go to bed. I picked up a dog bed for him earlier when I got everything else.”
“What about your ghost friend?” she asked, looking around the room. “Where does he sleep? Wait, does he sleep? Hold it. He’s not
sleeping with you, is he?”
“He goes off into what he calls a gray space. He’ll just disappear until, well, I don’t know how this is going to work, actually. I don’t think he sleeps like we do, though. And I’m not dignifying that last question with an answer!”
“I don’t. But I do rest, I guess you could say, while I recover my energy,” Rand said. “And thank you for that. I think.”
Sam considered this, then in a whisper, asked, “He won’t spy on us or anything, right? In the bedroom or the shower or anything?”
“She knows I can hear her, doesn’t she?” Rand smirked, looking slightly affronted. “And I would never do that. I was raised better than that. Besides, if I so much as thought about it, I’m sure Elmer would find a way to come back and tan my hide.”
Sheesh. “No, he would never do that,” I reassured her. “Sam, I really need to go to bed or I’m going to pass out right here.”
“Fine. Go. I’ll bring Toby up when I go to bed. Goodnight.”
With a wave, I headed up the stairs. As I glanced back at Rand, I saw him look at Toby and then blink out. This day had been a wild one and my emotions had completely sapped me. I was out as soon as my head hit the pillow.
Chapter 2
When I woke the next morning, Toby was still snoring away on the bed I had bought him. Sitting up, I realized I hadn’t even heard Sam come up to her room last night. Heck, I hadn’t even gotten up during the night for potty breaks, as my bladder was urgently reminding me now. Yesterday had taken more out of me than I realized, if I’d slept that heavily.
Practically crossing my legs as I fast-walked to the bathroom, I almost moaned with relief when I got there. I was going to be fortyone this Saturday and my bladder liked to remind me I was getting older daily. As I washed my hands and face, I looked at myself in the mirror. My eyes were still a little puffy from crying. I wasn’t normally much of a cryer - mostly just when I was angry, but I had cried pretty hard when Elmer crossed. He was where he wanted to be now, I knew, but I still missed him. I slathered on moisturizer and something to help take some of the puffiness away from around my eyes. Ignoring the big streak of grey in my hair–I still needed to get that taken care of–I pulled my hair back into its usual pony and headed downstairs, Toby practically glued to my side.
By the time I’d fed Toby and let him out to do his business, Rand still hadn’t made an appearance. Weird. Sam came in from her morning run just as the coffee I had put on finished brewing.
“Hey, Sam? Instead of doing a birthday party, how would you feel about me making up a few pizzas and inviting Annie and Tess over
as a thank you for all the help they gave me getting ready to move, since they won’t let me pay them or anything?” I asked.
“Don’t you want us to take you out for your birthday, like we usually do, Rox? I mean, if you’d rather stay in, we can do that instead. When did you have in mind?” I noticed her glancing around the room, trying not to be obvious. It took me a moment to realize she was looking for Rand.
“Well, I suppose that would depend on your social calendar with Dr. Hottie now, wouldn’t it?” I teased. Sam was still seeing the doctor I’d had during my stay at the hospital, courtesy of Steven’s fist.
“Psh. As of right now, there are no plans written in stone. Pick your own punishment, girlfriend. I’d rather have your pizza than a man, anyway!”
“How about this Friday night? Seven o’clock? Why don’t you invite Leo?”
“I’ll let the girls know. I’ll talk to Leo and see if he’s free. Where’s your . . . friend? Is he here?” she asked, trying to sound casual.
“No clue. I haven’t seen him at all this morning. He might have overdone it yesterday.” I shrugged, not worried yet. “Elmer was the same way. Sometimes it would be a couple days before he would show up.”
“Mmm. Okay, then.” She visibly relaxed as she started for the stairs. “I’ve got to get ready for work. It’s so weird seeing you this early in the morning.”
Laughing at that, I pointed at the sliding glass door, just as Toby came up onto the deck. “I’ve got responsibilities now.”
Friday arrived like a blur. Jake had finally reappeared two days ago. He and Toby played like fiends in the yard and at the park. Whenever Jake was present, the two dogs were inseparable. Jake disappeared most afternoons just before Sam got home, which made me wonder if that was a habit from before. Thinking that, I missed Elmer again. I kept reminding myself he was exactly where he wanted to be now and that made it easier.
Rand had only made a couple of brief appearances, mostly for Toby’s sake, I think. Once, he’d popped in just as I was heading out to take Toby to the dog park. When I asked him if everything was all right, he assured me he had just needed more time to recover than he’d thought. The next time he showed up, I was out on the deck, studying a few of Elmer’s journals, Toby content at my feet. He had tried to read over my shoulder at first, but said the writing didn’t make much sense to him. After a few minutes of this, he sat in one of the deck chairs and kept me company while I continued to look through the journals, trying to find anything that might be useful to my situation.
That had answered one of my questions, though. The last time I’d called Grandmam and Rosemary back, they could read the journals without the help of the Decoder Ring I had to wear to read them. I had been wondering exactly how close a ghost’s ability to See was to mine. Some of the things Elmer and Rand had described about their encounters with Others differed from each other's experiences. And, thinking back to my encounter with the witch when I had been pulled into a journal entry, what I saw didn’t jive
with either of their descriptions, either. Something about all of that didn’t sit right in the back of my mind, but I couldn’t quite put my finger on why.
Most of my afternoon was spent preparing pizzas. Cheating with the salad, I had driven down to VG’s in Fenton and picked up one of their family size caesar salads. The pizza sauce had already simmered for hours, the dough had been kneaded, allowed to rise, kneaded again, and was now rolled and pushed out onto the pans. The toppings were all organized and just needed to be layered on.
Three large pizzas plus the salad should be enough for the five of us–Sam had invited Leo after all. Looking around, I finally felt in control of everything for the moment. No ghosts, no magick stuff–just the comfort of losing myself to the familiarity of this.
Everyone would be arriving in about an hour, so I started layering the toppings on. One Hawaian style, one heavy on the meats, and one Mexican. Popping two of them in the oven, I got to work on cleaning up the mess. By the time Sam walked in the door, I was just putting the last pizza in the oven and setting the table.
“That smells unbelievable, Roxie. I’ve been thinking about this all day. Tess and Annie should be here soon so I’m going to run up and change, real quick.”
Over the last few days, Sam had relaxed quite a bit, once she realized Rand wasn’t hovering around everywhere we were, all of the time. Now that I thought about it, maybe that’s precisely why he hadn’t been around so much—he knew I wouldn’t deliberately lie to her if I didn’t have to. Her trial agreement had made him nervous enough that he was probably going out of his way to make sure she
felt more at ease. Shaking my head, I realized how much sense that made now.
I went upstairs to change my own flour covered clothes and freshen up before everyone got here. Toby followed me but stopped at the door when I told him to stay. He gave me what had become his usual growly grumble and settled down on the threshold when I shut the door. As foolish as it seemed, I just couldn’t bring myself to change clothes in front of him. Heck, I had rarely changed clothes in front of Steven, especially after he started sniping about my weight.
Sighing at that unpleasant memory, I examined myself in the full length mirror. At forty-one, well, tomorrow, anyway, I didn’t think I looked bad. The twenty pounds I had lost while my jaw had been wired shut were still gone. The walks to the park and the daily half a dozen trips up and down Sam’s stairs had started toning my muscles a little. My clothes draped nicely on my figure now and the slight belly I had before was nearly gone–I actually had a waistline again. Seeing some of my hair pulling loose from my hair tie, I pulled the tie out and ran my fingers through to give my hair a little volume. Except for the gray stripe from my head injury and a few stray grays creeping in at my temples, my auburn hair was thick, with lots of natural wave. Sam thought the odd patch made me look like a badass. Now that I had gotten sort of used to it, I thought maybe she was right. I moved my part a bit so that the grey framed each side of my face. I could live with it, I decided.
Sam’s door across the hall opened and I heard her talking to Toby. I hurried over to the door, opened it and told Toby he was ‘free’, so he would head downstairs with Sam.
“I can’t believe how well trained he is,” she marveled for about the tenth time since I had brought him home. “That woman who left you at the park was an idiot, wasn’t she, you good boy?” Toby cocked his head to one side at her baby talk, his tail wagging hard enough to thump the wall.
Oh my god, I needed to record this some time. “I’m just going to touch up my makeup really quick and I’ll be down. The last pizza should be ready in seven or eight minutes, if you don’t mind taking it out if I’m not down by then.”
“No problem. Come on Tobes, let's go get you a treat.”
“He’s not a baby, Sam, he’s a dog. And lay off the treats already, he’s starting to beg for them every time I go near that cupboard,” I yelled after her. She had gone out on her lunch and bought about five different kinds of treats and biscuits for him, the day after I’d brought him home.
My makeup wasn’t that bad, so it didn’t need too much touch up. Powder, mascara, a little blush and lip gloss, and I was back in the kitchen just as the oven beeped. I pulled it out and set it in the warmer with the other two. Yes, Sam’s kitchen would have made any professional chef drool.
Tess was the first to arrive, hugging me as she walked in, with Leo only minutes behind her. We went through the ‘friend’ routine with Toby, Sam showing him off as if she had trained him herself. While she kept them entertained, I pulled the pizzas out and set them on the huge farmhouse table, along with the salad. By that time, Annie was just walking in.
“Sorry I’m late, guys, but my mom got stuck in traffic,” she apologized, coming straight into the kitchen, and giving me a hug. Her shirt today read ‘I do this thing called whatever I want’.
“Cammie was so excited her grandma was coming over to stay with her, she practically shoved me out the door. But I’m free for the whole night, so there better be wine.” Annie was a single mother of a special needs child and her mother was the only one she trusted with her daughter for any extended length of time.
“It’s okay, I’m only just finishing up here. They’re all in the other room, mooning over the dog.”
“Sam got a dog? When did that happen?” Annie’s surprise was almost comical. She had known Sam just as long as I had.
“Long story, but he’s not hers. He’s, well, he’s mine.” It still felt weird saying that. In my mind, Toby still belonged to Rand. He was just my responsibility. “I’ll explain over dinner.”
Her eyes lit up as she looked at the pizzas laid out on the table. “Is that a Mexican pizza? With jalapeños? You’d better tell them to get their butts in here so we can eat!”
“How about you tell them that? Let me introduce you to Toby, first, though.” I called for him and he came right to me, sitting almost close enough to be touching my leg and looking up at me expectantly. “Toby, friend.” I touched Annie’s arm as I said this. He woofed and looked at Annie, tail wagging.
“Um, wow. I was expecting, I don’t know, like, a little dog. Maybe one of those fancy kinds that like to be carried around in a purse or something, not a dog that looks like he would take my arm off if you told him to!”
“Toby ‘free.’ Go meet Annie.” I watched as Annie stiffened at the big dog’s approach. He sat at her feet and put his large paw on her foot, the same way he had when he first met Sam. I would have to ask Rand about that.
“I can pet him now? He won’t bite?” she asked skeptically.
“It’s all good. He knows you’re okay.”
She gave him an awkward pat on the head. “Good dog. You can go now.”
“You don’t like dogs?” I asked, incredulous.
“I like them plenty from further away,” she said, grimacing.
The rest of the gang chose that moment to walk in and Toby trotted back to them, prancing a little next to Sam. He knew who his fans were.
As we sat down to eat, Sam stepped away to grab a bottle of wine from the wine fridge–yes, the woman had a special refrigerator just for wine. She poured for all of us and then we dug in, making small talk between bites of pizza dripping with cheese. Tess already knew what happened, since she worked with Sam, but I told the story about what had happened at the park again for Annie and Leo’s benefit.
“I’m glad you weren’t seriously hurt, you’ve spent enough time in the hospital.” Leo sat back and looked over at Toby. “But why would anybody abandon such a well-trained dog. To put so much time into him and then just leave him? That doesn’t make sense.”
“Oh, she wasn’t his first owner. She got him from the shelter. She didn’t even know his background other than his owner had—” I
stopped abruptly, realizing I’d said too much. It must be the wine.
He turned to me, considering for a moment. “How is it you know so much about him? You know his training, his commands–those tend to be unique. Most dogs with training like his are quite hard to come by. What is he, ex-police? A friend of mine has been on a waitlist for quite awhile for a dog like him to become available.”
Swallowing hard, I looked to Sam for help. She didn’t fail me.
“Roxie was extremely lucky she was able to track down his history through his microchip. He used to be a—what was he again, Rox?” Cucumbers weren’t even as cool as Sam was at that moment.
“H-he was a cadaver dog. But he didn’t make it all the way through the training. The man who adopted him was, um, he was shot,” I said nervously. “That’s how Toby ended up at the shelter. When Cruella, I mean the lady that adopted Toby after–well, I’ve already told you that part, I guess.” I finished rather lamely, taking a big sip of my wine.
“I hope you know what a lucky dog you are, Toby,” Leo said to the dog. Toby’s ears pricked up comically as he heard his name. “It sounds like you just won the lottery getting to live with these two lovely ladies.”
Sam blushed prettily, at least. I could feel my ears turning warm as I fanned myself with a napkin.
“What, did I put too much ham on that Hawaian pizza? It’s getting thick in here.”
We all laughed at that, the mood instantly lighter. After dinner we cleared the table and moved into the living room. Leo regaled us with stories about some of the more humorous things he’d
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When the disease has existed for a certain time, sub-epithelial hæmorrhages, ulcerations, vegetations and points of sclerosis may all co-exist, a fact which shows that the disease does not develop all at once, but that, on the contrary, every little lesion develops separately and continuously. This fact also explains the length of time for which blood may be passed, despite the presence of old or healed lesions.
Finally, in very old standing cases dating from several years back (Moussu saw an animal aged twenty-eight years which had suffered from this disease for more than twenty years, but in a very intermittent fashion), it is not exceptional to find numerous papilliform vegetations 1 or 2 inches in length, either with a fine pedicle or largely sessile, invading one-half or two-thirds of the internal surface of the bladder.
These vegetations sometimes, though rarely, invade the ureters. When they occur towards the point where these conduits enter the bladder, they obstruct the passage of urine, and lead to the development of hydro-nephrosis or pyelo-nephritis.
Symptoms. The early symptoms often escape notice, because general disturbance is rare. The first appreciable signs are cystitis and frequent urination.
The urine passed is turbid, particularly towards the end of the act of urination; then it is of a pink or red colour, and all intermediate shades between a pale pink and a bright arterial red colour may be observed.
The patients sometimes seem to pass unaltered blood in the urine, but on microscopic examination this blood is found to be extremely diluted. Provided the bladder is not gravely infected by the (secondary) penetration of germs into its cavity the blood corpuscles remain normal, or are scarcely changed. As soon as the bladder, however, becomes secondarily infected an almost immediate change takes place; the red blood corpuscles become crenated, broken up and dissociated; the hæmoglobin is also partly dissolved and modified, and at this stage the urine is red-brown or coffee-coloured, according to the length of time it has been retained in the bladder.
In other cases, chiefly when hæmaturia has existed for some time, the extravasated blood coagulates in the bladder, and the urine passed contains filamentous clots the size of a man’s thumb, a
pigeon’s egg, or more. If the clots formed are too large to be passed, which is often the case in the ox, they may obstruct the urethra, causing retention of urine and all the accidents which accompany this condition, even including rupture of the bladder. This, in the ox, is a frequent termination. In the cow the dilatability and shortness of the urethra render retention of urine much rarer. It is certainly possible, however, and it is not exceptional, to find from 4 to 6 lbs. of clotted matter in the distended bladder. All these conditions can be detected by rectal exploration, and by attention to the symptoms of obstruction of the urethra.
Whenever there is retention of clots dysuria is extremely marked and, so to speak, permanent, the animals having continual tenesmus.
Hæmaturia observes a slow, progressive course, which, in time, ends in death by exhaustion, though this is not invariably the case. Hæmaturia is frequently intermittent, and, after having been very marked for weeks or months, may suddenly or gradually cease, and only reappear a long time afterwards. This fact is explained by a study of the development of the lesions. When ulceration occurs the sub-epithelial vessels of the mucous membrane, which have contributed to the formation of the hæmorrhagic spot, are widely open, and a capillary hæmorrhage results; but as soon as a small clot forms in this position, or local capillary thrombosis occurs, the hæmorrhage ceases, with the result that the hæmaturia disappears. Unfortunately, however, the obliterating clots are not permanent, any more than the local thrombosis—or, in the event of their proving permanent, another small lesion develops at a different point, and this lesion may at any time cause the reappearance of the hæmaturia; the process goes on until the animal succumbs. Should the lesions heal successively, spontaneous recovery may take place, but such recovery is exceptional.
The animals may not appear to suffer from the passage of blood for weeks or even months, but after a time they become less capable of replacing the loss. They become anæmic, the number of corpuscles falls from the normal figure of from six to seven millions of red corpuscles per cubic millimètre to three millions, two millions, one million, and even to five hundred or eight hundred thousand.
The richness in hæmoglobin simultaneously diminishes; wasting progresses to the point of cachexia, and the appetite diminishes
while diarrhœa appears; swellings are noticeable about certain parts of the body; and the animals, continuing to pass blood, die in a state of absolute exhaustion, without apparent suffering.
This termination is the most common, unless slaughter is determined on, and is very different from the premature end which follows the formation of clots and obstruction of the urethra.
Externally the patients only show feebleness, pallor of the visible mucous membranes, and difficulty in urination. The bunch of hair at the lower commissure of the vulva is always soiled with bloodstained urine or little clots.
Hæmaturia may cause death by exhaustion in from six weeks to two months, but not infrequently it lasts for months or even years.
Diagnosis. The diagnosis presents no difficulty when the urine can be examined; but in the periods of intermittence no opinion can be advanced. These intermittences are so frequent that in parts of the country ravaged by this disease it is a usual custom, when selling, to grant or refuse guarantees for a longer or shorter term.
The condition can be distinguished from parasitic hæmoglobinuria (piroplasmosis) or from Brou’s disease (a febrile disease of rapid development) by simply examining the urine or blood.
Prognosis. The prognosis is extremely grave, for, up to the present, no really efficacious treatment has been discovered, and although some animals may live for years without their lives being in any way endangered, this cannot possibly be foreseen, and there is no economic advantage in keeping them.
Treatment. No curative treatment is known.
It is true that iron salts, tonics, Rabel’s liquid, decoctions of certain plants, such as plantain, have been recommended, but apart from the fact that they are of doubtful efficacy, they cannot be used over long periods. All these preparations also tend to increase the coagulability of the blood; but considering that the disease is beyond question of a parasitic character, good results cannot always be expected of them.
Preventive treatment appears more hopeful, although even in this connection, the best informed appear to have considerable doubts. All those who have studied the question agree in recommending drainage of the pasturages, and their improvement by the use of various manures, particularly superphosphates and lime. These
improvements alter the character of the pasture, render the soil healthier, and may perhaps prove sufficient to diminish or prevent the local growth of the germs. Under such conditions, Boudeaud declares that he has seen hæmaturia disappear from farms where it had previously been in permanent possession. It has also been recommended that the affected cattle should be sent elsewhere to places where the disease does not exist, and experience shows that spontaneous recovery is more frequent under such conditions.
It is probable that, during attacks of hæmaturia in a contaminated country, successive parasitic infestations occur, which would explain the persistence with which blood is passed, a symptom which does not occur in a healthy country. This view, however, is still only an hypothesis.
CHAPTER III.
DISEASES OF THE KIDNEYS.
CONGESTION OF THE KIDNEYS.
Congestion of the kidneys is not a morbid condition in the strict sense of the term, for it is merely the forerunner of nephritis caused by infectious diseases or intoxications (primary active congestions) or the final consequence of other diseases, such as diseases of the heart or liver, mechanical compression of the vena cava or renal veins (secondary passive congestion, cardiac kidney).
Nevertheless, under certain circumstances the development of nephritis may be arrested at the primary congestive stage, and it is only then that an opportunity occurs of studying it as a definite complaint.
Causation. All infections accompanied by lesions of the kidneys, and these are numerous (gangrenous coryza, anthrax, parasitic hæmoglobinuria), produce congestion of the kidneys.
Cold also acts directly under certain conditions, as do large doses of diuretics, irritant foods the principles of which are eliminated through the urine (fermenting or putrid sugar-pulp, for example), and foods rich in resins, essential oils, various glucosides, tannin, etc. (young shoots of trees during the spring-time).
Symptoms. The symptoms are difficult to define accurately, and the diagnosis can only be arrived at with the aid of the history.
Renal congestion produces pain, indicated by dull colic and repeated and ineffectual attempts to urinate, suggesting acute cystitis. The patients lose appetite, and present all the general symptoms of marked visceral inflammation, viz., fever, acceleration of breathing, somewhat tumultuous action of the heart, etc.
External or internal examination of the kidneys reveals abnormal sensitiveness. The urine is of a dark or bright-red tint, owing to the presence of red blood corpuscles. These blood corpuscles are precipitated on placing the fluid in a tall glass, and can be detected, together with renal epithelium, by microscopic examination.
The diagnosis is somewhat difficult, and it requires very careful attention to distinguish between congestion of the kidney and true nephritis.
The prognosis should always be reserved until it is certain that acute nephritis will not ultimately develop.
The treatment consists in removing the cause of the congestion; rich foods, or foods containing irritant principles, should, therefore, be avoided, as also the administration of diuretics, etc.
Otherwise, the treatment is similar to that employed in all visceral inflammations: bleeding to the extent of two to four quarts, according to the size of the animals, warm poultices to the loins and flanks, dry friction, mucilaginous drinks and emollient decoctions of barley or pellitory. The animals should be kept in a warm place.
In cases of passive and secondary congestion, treatment must be directed towards improving the condition of the organ primarily affected, whether it be the heart, liver, or lymphatic glands.
ACUTE NEPHRITIS.
The term nephritis applies to inflammation of the renal tissues. Clinically, two forms only can be distinguished, the acute and the chronic.
As regards its pathological anatomy, the inflammation may principally affect either the interstitial tissue or the epithelial parenchyma, a fact which has suggested the division of the condition into epithelial nephritis, interstitial nephritis, and mixed nephritis. Clinically, such distinctions are impossible; and in reality all forms of nephritis are to a varying degree mixed, the lesions predominating in one or other of the constituent tissues. These lesions depend on the extent, intensity, and duration of the inflammatory attack, whatever the primary causes. All the constituent tissues of the kidney may be affected, simultaneously or individually: the Malpighian corpuscles, the convoluted tubules, the collecting tubules, or the interstitial connective tissue.
Causation. Cold seems to be an important factor. All acute or chronic intoxications in which the toxic principles are eliminated by
the kidneys, such as poisoning by cantharides, fermented beet pulp, young shoots of trees or toxic plants, may cause acute nephritis.
Infectious diseases, such as gangrenous coryza, hæmoglobinuria, tuberculosis and post-partum infections, also play an important part, whether the nephritis be direct, that is to say, the result of the infecting agent itself, or indirect, i.e., produced by toxins generated in the body. In female animals gestation is an often unsuspected cause. Moussu believes that albuminuria is frequent during gestation, and although in most cases it is only of moderate degree, he thinks it is often associated with subacute nephritis, which might be aggravated by an accidental cause.
Many forms of nephritis are overlooked in consequence of their slight character.
Symptoms. The early symptoms are similar to those of congestion of the kidney, viz., dull colic, excessive sensitiveness over the region of the loins, passage of pink urine, loss of appetite, and fever. At a later stage, in cases of acute nephritis due to cold, the animal stands with the limbs close together and remains stationary, arching the loins and back, which are held stiffly. The animal obstinately refuses to move in consequence of the pain produced by so doing.
The general condition becomes grave, respiration is rapid, the pulse frequent, the artery tense, the muzzle dry, the accessible mucous membranes are injected, and appetite is almost entirely lost.
Urine is frequently passed, but the act causes pain, and the quantity is small. Absolute anuria is rare, and does not last long.
The urine is generally sanguinolent, at least at first, but to a very varying extent. It is always albuminous, the quantity of albumen varying enormously, and on microscopic examination, is usually found to contain red and white blood corpuscles, epithelium from the kidney hyaline or epithelial cylinders, and, towards the end, pus corpuscles.
Œdema or anasarca, though common in mankind, does not occur in a very marked form, except in intense acute nephritis. Epistaxis is also rare.
Diagnosis. The diagnosis requires some care, because unless the urine be examined the symptoms might lead to error. Nevertheless,
it is always possible to distinguish between this condition and hæmaturia or accidental renal hæmorrhage.
Prognosis. The prognosis is grave, because absolute recovery is rare, and because the condition is very apt to become chronic.
The degree of anuria and the respiratory difficulty are of great service in confirming the prognosis. As soon as urine is freely passed the prognosis becomes more favourable.
Treatment. Among the most effective methods of treatment must be included bleeding, which always produces some improvement. Dry friction over the kidneys and flanks, hot moist applications, and the application of a sheep-skin to the loins are also of service. Internally, mucilaginous drinks, diuretic decoctions and milk give the best results. The proportion of albumen rapidly diminishes, dysuria becomes less marked, urine is passed in greater quantities, and in from eight to ten days all the alarming symptoms disappear. Bicarbonate of soda may then be given for a fortnight.
In very grave cases camphor, bromide of camphor, injections of camphorated oil (1 to 2½ drachms internally, or 1 to 1¼ drachms in subcutaneous injections) give excellent results in modifying the pain and moderating the inflammation.
From ½ to 1 drachm of digitalis in powder, or better still an injection of from 5 milligrammes to 1 centigramme of digitalin may also be given when dyspnœa is very great and is accompanied by anasarca. Medicines such as oil of turpentine and considerable doses of nitrate of potash, however, are contra-indicated.
CHRONIC NEPHRITIS
True chronic nephritis, i.e., a condition strictly limited to the renal tissue, and unaccompanied by pyelitis, is still little known among our domestic animals. The symptoms characterising it have not always been carefully noted, and the diagnosis is very often uncertain. Nevertheless, one of the most common forms has been carefully studied by Seuffert, viz., chronic hypertrophic nephritis.
Causation. Chronic nephritis is the common sequel to the acute forms, whatever their origin, but it may also occur primarily from
repeated chills produced by such conditions as exposure to heavy continued rain when at grass, chills contracted during cold nights and the great variations in temperature in spring and autumn. The conditions, however, thus produced are rather of the nature of subacute nephritis than of chronic nephritis, properly so called.
These forms of chronic nephritis may also occur primarily in consequence of chronic hepatic lesions with pressure on the posterior vena cava, producing blood stasis in the kidneys. Finally, they may represent the delayed effects of slight lesions which have escaped notice and have developed during grave diseases or as a consequence of repeated gestation.
From the anatomico-pathological standpoint, the only conditions hitherto recognised are the chronic hypertrophic forms of nephritis (large, white sclerotic kidney with lardaceous degeneration and sometimes marbling). This is probably because the animals are slaughtered as soon as they suffer in condition, but if they were kept long enough they would undoubtedly suffer also from the atrophic chronic forms of nephritis found in man and in the dog. In the case of man observation has shown that these two forms only represent different stages in the development of one disease, the large, hypertrophied kidney of the early stages afterwards undergoing marked progressive atrophy.
The symptoms are at first so vague that diagnosis would be impossible on a single examination. Seuffert states that the condition develops as follows:—
The first sign, loss of appetite, is soon followed by constipation and dull colic, due to congestion of the kidney; the pain is often so great as to cause intermittent groaning.
The urine passed is always turbid, and sometimes blood-stained, but this staining rarely lasts longer than a week. The urine then gradually resumes its normal appearance, is passed in small quantities, and contains more or less albumen. The yield of milk markedly and progressively diminishes.
If treatment is resorted to at this stage laxatives and diuretics appear to effect a real improvement. Unfortunately, however, the apparent improvement is but temporary; the kidneys become hypertrophied, and the right soon occupies the whole of the
sublumbar space, its margin extending as far as the extremity of the transverse processes near the anterior angle of the hollow of the flank.
This hypertrophy and the extreme sensitiveness can be detected by external palpation. Internal examination confirms the facts so observed as regards both the kidneys.
The patients eat little and become thin, whatever treatment be adopted. They progressively waste, and die after some months in a state of marasmus, exhausted and intoxicated.
It is very probable that the digestive disturbances are complicated by respiratory and cardiac trouble, as in man and the dog; but neither cardiac nor uræmic disease of the kidney has been recorded.
Diagnosis. When the urine is analysed the diagnosis becomes comparatively easy. Persistent albuminuria and hypertrophy of the kidneys during the early stages are significant indications. There can be little hesitation except in so far as pyelo-nephritis and hydronephrosis are concerned, but the conditions are distinguished by the character of the urine in the two latter cases, together with the condition of the pelvis of the kidney, and of the ureters.
Prognosis. The prognosis is grave, and Seuffert believes that recovery never occurs. This is also true, generally speaking, as regards all forms of chronic nephritis.
Treatment. As the disease must be regarded as incurable there is really no justification for treatment. Nevertheless, if for special reasons the owner wishes to keep the animals for a certain time, as in the case of a cow near its time of calving, recourse may be had to the internal treatment suggested in acute nephritis, viz., mucilaginous drinks, diuretic infusions, milk, bicarbonate of soda, stimulating applications to the loins, etc.
HYDRO-NEPHROSIS.
Hydro-nephrosis, i.e., retention of urine in the pelvis of the kidney and in the collecting and secreting tubules, is a somewhat common malady of the bovine species. It is usually confined to one kidney.
F . 228.—Hydro-nephrosis of the kidney.
Causation. Anything which obstructs the discharge of urine through the ureters may cause hydronephrosis. Thus, vesical tumours pressing on the orifices of the ureters, calculi which have become fixed in them, torsion or “kinking” of the ureters, may bring about hydronephrosis. The urine secreted by the kidney being unable to escape,
accumulates in the pelvis of the kidney, in the ureter, and uriniferous tubules, producing dull colic, which escapes observation, or the exact cause of which is not discovered, because the second kidney vicariously acts for the one affected, and urination continues regularly. Secretion continuing in spite of the obstruction, that portion of the ureter above the obstructed point, together with the pelvis and the uriniferous tubules, gradually becomes dilated, until the whole mass of the kidney is hypertrophied.
The ureter sometimes becomes enlarged to the size of a man’s arm, the kidney double, treble, or quadruple its normal side: the interlobular divisions are lost, and each circumscribed lobule soon forms a cystic cavity varying in size. The pressure due to the accumulated urine causes the renal tissue, first the medullary substance and afterwards the peripheral zone, to undergo atrophy.
The kidney is represented by a vast cystic cavity, and the lobules by culs-de-sac; the cortical layer may become atrophied to such a degree as to form merely a fibrous sheath, the primary constituent elements of which are difficult to discover. From 20 to 40 pints of liquid may sometimes be found in the cystic kidney.
Diagnosis. The condition is rarely diagnosed, because, as one of the kidneys continues to act, no acute disturbance follows. Only in cases where the cystic kidney projects into the flank are suspicions aroused. Examination per rectum will then permit of the diagnosis being made.
Prognosis. Hydro-nephrosis being, as a rule, unilateral, the prognosis is not very grave as regards immediate danger. As the condition is hopeless, however, the lesions being irreparable, the animal should be prepared for slaughter.
Treatment. Practically there is no treatment. Puncture of the cystic cavity or even the removal of the hydro-nephrotic kidney certainly suggests itself, but, as such operations are usually opposed to the interests of the owner, they are rarely or never practised.
INFECTIOUS PYELO-NEPHRITIS.
F . 229. Section of a kidney affected with hydro-nephrosis. The gland substance is almost entirely atrophied, and each lobule shows marked dilatation.
The term “infectious pyelo-nephritis” describes an inflammation which may involve any portion of the mucous membrane of the urinary tract, and which is produced by a special bacillus. As a rule, this inflammation commences in the mucous membrane of the calices and pelvis (pyelitis). It afterwards extends into the depths of the uriniferous canaliculi (nephritis), but in grave and old-standing cases the mucous membrane of the ureters and the bladder may also be affected. The disease had long been known in France (Rossignol, 1848). It was afterwards described in Germany (Siedamgrotsky, 1875; Pflug, 1876), in Switzerland (Hess, 1888), and also in France (Lucet, 1892; Masselin and Porcher, 1895).
Causation. Female animals are more frequently affected than males, because the lesions are produced by an ascending infection,
originating very frequently in genital infection after delivery. Nevertheless, calculus formation is also an important factor in producing the disease.
Many different agents are capable of producing pyelo-nephritis. Hofflich in 1891 described a bacillus about 2 to 8 micromillimètres in length, which stained readily with aniline colours and with Gram solution. Lucet in 1892 found a short bacillus which did not stain with Gram, and later another thin bacillus which did. Kitt has described cocci, but no other organisms. Masselin and Porcher discovered a cocco-bacillus which stained with Gram and reproduced the disease in an animal lent by Moussu, after a single intra-vesical injection of the culture. Cadéac has met with staphylococci, and Moussu has discovered various bacilli, some resembling the colon bacillus, and pyogenic streptococci.
There is no doubt that many different organisms may produce pyelo-nephritis by ascending infection. The most common seem to be forms of paracoli, such as the Bacillus ureæ. Moussu nevertheless believes that Hofflich’s bacillus, which was rediscovered by Porcher, is that which produces typical pyelo-nephritis. It grows in the bladder without producing cystitis, and is succeeded by an ascending infection of the ureters without causing primary ureteritis, the local inflammation occurring chiefly, it would seem, in the pelvis and the kidney. All the other organisms which Moussu has tested have caused lesions of cystitis and of ureteritis, together with those of pyelo-nephritis.
In these latter cases the pyelo-nephritis assumes the acute form, and is accompanied not infrequently by cellulitis and abscess formation in the tissue around the kidney.
Symptoms. Pyelo-nephritis develops in one of two principal forms, the slow chronic form, which is the most frequent, or an acute or subacute form, much more rapid in its development.
The chronic form for a time escapes notice. There is no doubt that at first some general disturbance occurs, such as diminution of appetite, disturbed nutrition, unhealthy general appearance, staring of the coat, tightness of the hide, wasting, etc., but such symptoms are in no wise characteristic, being found in all grave diseases.
The signs only become really significant from the clinical standpoint when the urine appears modified in character, and such modification does not occur until the pelvis of the kidney and the kidneys themselves are already gravely diseased.
The urine is then turbid, of a brownish colour, and charged with sediment, filaments of mucin, pus corpuscles, and earthy phosphates. On analysis it is found to contain more or less albumen.
At a late stage it may even become glairy, blood-stained, or of the colour of blood, and when the pelvis or the calices of the kidney are ulcerated may, on standing, deposit considerable quantities of red blood corpuscles.
F . 230. Pyelo-nephritis with hæmorrhagic pyo-nephrosis of one side. One ureter is dilated and blocked with a blood clot.
Exposed to the air, the urine rapidly assumes a brown tint and smells strongly of ammonia.
Percussion of the loins in the region of the kidneys causes pain, as does external palpation by the flank. On rectal examination at this period the ureters are found to be distended and hard, and they give the impression of rigid or bosselated fibrous cords, sometimes as large as a child’s arm. The corresponding kidney, often both kidneys, are enlarged, sometimes to double or treble their normal volume, and are painful on pressure and fluctuating, at least in the region of the pelvis. On vaginal examination the meatus urinarius is usually found to be inflamed, rough and turgid.
In this condition the animals rapidly lose flesh, the appetite becomes irregular, the general condition gradually gets worse, and they die as a result of continued uro-septic fever or uræmic troubles.
The acute form takes a much more rapid course, with fever, more marked general disturbance, acceleration of pulse and breathing, the passage of turbid and sometimes purulent urine with a strong ammoniacal smell. Pyo-nephrosis is the most frequent and characteristic end. Ordinary chronic pyelo-nephritis may also occur in these cases, and the acute course may be determined simply by accidental ascending infections.
Diagnosis. During the early stages diagnosis is extremely difficult, unless a careful examination of the urine be made. Afterwards it becomes easy, the appearance of the urine and the indications furnished by rectal exploration being perfectly characteristic. In very exceptional cases there may be some doubt, as where the urine remains normal, in spite of hydro-nephrosis, or where there is old-standing hæmaturia or renal tuberculosis. In simple hæmaturia the lesions are confined to the bladder and ureters, the kidneys not being affected, and in renal tuberculosis the diagnosis can always be confirmed by the use of tuberculin.
Prognosis. The prognosis is extremely grave, for the lesions produced are irreparable, and, moreover, local intervention is impossible.
Treatment. There is no curative treatment. All that is possible is palliative treatment with the object of facilitating the function of the kidney and of disinfecting the urinary passages by administering
antiseptic substances which are excreted by the kidney. It is not possible, however, to administer active drugs of this kind (e.g., combinations of carbolic acid). As the kidney acts badly it soon ceases to eliminate such substances, and the condition would not be improved, but aggravated.
Benzoate of soda in doses of 2 to 2½ drachms per day dissolved in diuretic liquids is the most useful drug, and sometimes holds the disease in check for a sufficient time to allow of the animals being fattened.
Treatment also comprises certain prophylactic precautions. As the infection which produces pyelo-nephritis originates in the genital tract, it is desirable to protect all animals in a receptive condition (those about to calve or having recently calved) from infection; hence, when the disease is detected in a cow-shed, the patients should be isolated, and the shed thoroughly disinfected.
SUPPURATIVE NEPHRITIS AND PERINEPHRITIS.
Suppuration of the kidney may occur under two conditions. In the majority of cases such suppuration occurs as a complication of pyelonephritis; less frequently it is the consequence of infection from within or infection of adjacent parts, leading to the formation of an abscess.
When it results from an ascending infection the kidney becomes swollen, congested and inflamed, and soon displays localised minute hæmorrhages. Pus then forms within the calices, in the large straight tubes, and diffuse suppuration invades all the uriniferous tubules. The enlarged kidney is yellowish, firm under the knife, and when sections are compressed pus exudes from the openings of the tubular canaliculi.
When suppurative nephritis has resulted from accidental infection of internal origin, an abscess is found to have produced more or less extensive atrophy of a portion of the kidney while not affecting the rest of the organ.
It is only in those favourable cases where the renal abscess opens into the pelvis that suppuration may invade the whole of the kidney, producing diffuse suppurative nephritis by secondary infection of the
uriniferous tubules. Such complications are rare. Usually the abscess empties through the pelvis, and recovery may occur.
More frequently suppurative pyelo-nephritis develops, together with ureteritis, cystitis, dilatation of the ureters, dilatation of the pelvis of the kidney, and dilatation of the collecting tubules of the pyramids, the final stage resembling the lesions of pyo-nephrosis.
Perinephritis and perinephritic cellulitis, i.e., inflammation with or without abscess formation in the connective tissue and adipose layer surrounding the kidney, always occur in cases of suppurative nephritis or pyelo-nephritis. Such inflammations may also, in exceptional cases, follow direct mechanical injury, but they almost invariably represent complications, the organisms infecting the kidney passing through the tissues and the layer of fibrous tissue, or extending by the lymphatic paths, finally attaining the fatty tissue surrounding the kidney and there undergoing multiplication. The fatty tissue is infiltrated with reddish serosity, is inflamed, and may become the seat of large abscesses communicating with or separate from the abscesses of the kidney itself.
Symptoms. Suppurative nephritis is characterised by fever, loss of appetite, arrest of rumination, and frequent attempts to urinate. These attempts are painful, are accompanied by groaning, and end in the passage of an insignificant quantity of blood-stained and purulent urine.
Palpation, more especially palpation of the right flank, percussion over the region of the loins, and examination of the kidneys through the rectum are painful. Wasting is rapid.
If the suppurative nephritis develops rapidly, and particularly if it be accompanied by perinephritis, the patients refuse to rise and appear to be suffering from paraplegia, although not really so, both sensation and motor power persisting in a greater or less degree. Probably the condition is accompanied by reflex pain and irritation of the nerve trunks of the lumbo-pubic plexus.
On the other hand, when suppurative nephritis tends to develop slowly and assume a chronic form, lesions of pyo-nephrosis gradually develop, and are identical in appearance with those of hydro-nephrosis, except that the ureters, the pelvis and the dilatations corresponding to the lobules, are filled with pus.
F . 231. Leaf lard around kidney of pig.
Diagnosis. The diagnosis is not very difficult. The urinary trouble and the composition of the urine itself always arouse suspicion. The diagnosis is confirmed by careful and methodical examination per rectum; the inflammation of the fatty tissue surrounding the kidney can usually be detected.
Prognosis. The prognosis is extremely grave, and almost always fatal, particularly in cases of diffuse nephritis.
Treatment. No curative treatment can be absolutely relied on. Treatment, if attempted, is limited to the methods suggested for pyelo-nephritis. Mucilaginous, emollient, and diuretic drinks, and daily doses of 2 to 3 drachms of benzoate of soda given in the drinking water, cause some improvement.
Stimulation of the region of the loins also undoubtedly has a favourable effect, and should always be practised, particularly where perinephritis is developing. It may check the course of the disease and prevent the formation of abscesses. On slaughtering animals suffering as above described the layer of tissue surrounding the kidney is found to be lardaceous and fibro-fatty.
Any treatment through the bladder is contra-indicated, for even the passage of a catheter may cause severe injury of the urethra or the vesical mucous membrane and produce a fatal aggravation.
If these conditions are diagnosed early, while the function of the kidney is more or less preserved, and if the animal is still in good
THE KIDNEY WORM (SCLEROSTOMA PINGUICOLA) OF SWINE.[7]
7. From Report of the U.S.A. Bureau of Animal Industry, 1899, p. 612. (Louise Taylor.)
In the United States of America a worm is frequently found in the fat surrounding the kidneys of pigs, and is supposed by farmers to be the cause of paralysis of the hind limbs.
This so-called kidney worm of hogs (Sclerostoma pinguicola) should not be confounded with the kidney worm (Dioctophyme viscerale) of dogs and man. Both of these parasites belong to the same zoological family (Strongylidæ), but to different subfamilies and genera. The kidney worm of dogs grows to a length of 1 to 3 feet. The kidney worm of hogs is much smaller, attaining at most something less than 2 inches in length.
F . 232.— Sclerostoma pinguicola. External view of female. a, Male, natural size; b, female, natural size; c, mouth; d, buccal cavity; e, œsophagus; f, intestine; g, anus; h, genital opening; i, condition, it should be slaughtered.
