Renal Failure in Horses

Aetiology

When >70% of nephrons lost

Less common than renal failure secondary to hypovolaemia (pre-renal failure)

Acute

Congenital

Interstitial Nephritis

Glomerulonephritis

Pyelonephritis

Amyloidosis

Neoplasia

Chronic

Toxic (NSAIDs, aminoglycosides, acorn)

Sustained marked hypotension

Clinical Signs

Depression, anorexia, weight loss

Polydypsia and polyuria

Oedema and diarrhoea

Pyrexia and colic signs

Encephalopathy

Oral mucosal ulceration

Excessive tooth tartar

Diagnostics

Urinalysis

Proteinuria

Casts

Pyuria

Haematuria

Isothenuria USG 1.008-1.014

Increased urine GGT

GGT: creatinine ratio to correct for variations in urine flow

Biochemistry

Azotaemia

Hyperkalaemia

Hyponatraemia

Hypercalcaemia

Hyperphosphataemia

Treatment

Acute Renal Failure

Restore circulating volume

0.9% NaCl 40-80ml/kg/day

Diuresis

20% mannitol and furosemide IV

Chronic Renal Failure

No specific treatment

Ad lib salt and water

High quality diet