Hyponatremia in horses refers to an electrolyte imbalance characterized by low sodium levels in the blood. Sodium is an essential electrolyte that plays a critical role in maintaining fluid balance, nerve function, and muscle contractions. In equines, hyponatremia can result from various conditions, including excessive sweating, diarrhea, or renal dysfunction. It may also occur due to inadequate sodium intake or excessive water consumption. Clinical signs of hyponatremia can include lethargy, weakness, and altered mental status. This page compiles peer-reviewed research studies and scholarly articles that explore the causes, clinical manifestations, and management strategies for hyponatremia in horses.
Ferlini Agne G, Kapusniak AE, Wooldridge AA, Jung SW.In this case report, a high dose of torsemide (6mg/kg, every 12 hours for 3 days followed by 12mg/kg, every 12 hours for 4 days) was administered orally to a horse with congestive heart failure (CHF) and atrial fibrillation. Blood samples for measurement of plasma torsemide concentrations were obtained one hour after each drug administration. Pharmacodynamic effects of oral torsemide were evaluated by daily physical examination, electrocardiography, and serum biochemistry. The horse tolerated administration of torsemide. A decrease in ventral oedema and venous congestion was subjectively noted...
Migliorisi A, Barger A, Austin S, Foreman JH, Wilkins P.Hyponatremia is common in horses with bacterial pleuropneumonia, but no further characterization of this abnormality has been reported. Objective: Describe admission plasma sodium concentration ([Na]) in horses with septic pneumopathy and evaluate any association of plasma [Na] with markers of systemic inflammation. Methods: Medical records of horses >1 month of age that between 2008 and 2021 had a transtracheal aspirate (TTA) performed, abnormal TTA cytology, positive TTA culture, pulmonary disease on ultrasonography, radiography or both, and plasma [Na] assessed by direct ion-selective-e...
Mullen KR.This article overviews metabolic disorders associated with renal disease. Included is a discussion of the pathophysiology, clinical signs, and treatment of hyperchloremic metabolic acidosis associated with renal tubular acidosis. Conditions affecting the central nervous system including uremic encephalopathy and hyponatremic encephalopathy secondary to renal disease are presented. Finally, a discussion of the unique features of calcium and phosphorus homeostasis in horses is provided with special emphasis on a recently described syndrome of calcinosis and calciphylaxis of unknown etiology.
Collins NM, Axon JE, Carrick JB, Russell CM, Palmer JE.To evaluate severe hyponatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) in order to determine the prevalence, clinical findings, primary diagnosis and outcome. Methods: Retrospective case study of records from Thoroughbred foals aged less than 3 months presenting to an ICU as medical emergencies in 2002-12; foals with severe hyponatraemia (serum sodium <122 mmol/L) on admission laboratory data were identified. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis, treatment and outcome. Results: Severe hyponatraemia w...
Hardefeldt LY.Four neonatal foals were presented, over a 2-year period, (2011-2012) with aimlessly walking, head pressing, 'chewing gum' seizures and ataxia. The neurological lesion was consistent with increased intracranial pressure in all cases. All foals had severe hyponatraemia and azotaemia identified on biochemistry. Hyponatraemia was transient in 3/4 cases, with the foal in the final case requiring long-term sodium supplementation. Three foals survived to hospital discharge; one was euthanased because of anuric renal failure and one of the surviving foals was euthanased with septic osteomyelitis 2 we...
Dunkel B, Palmer JE, Olson KN, Boston RC, Wilkins PA.Foals may present to a referral hospital with the primary diagnosis of uroperitoneum (UP), or they may develop UP while hospitalized for other reasons. Historical, physical, laboratory, and diagnostic variables of foals presenting with UP were compared to those developing UP while hospitalized. Emphasis was placed on the presence of electrolyte abnormalities, evidence of sepsis or infection, and development of anesthetic complications during surgical correction of the defect. Foals developing UP while in the hospital frequently had a history of dystocia and presented at a very young age (< ...
Magdesian KG, Hirsh DC, Jang SS, Hansen LM, Madigan JE.To determine molecular characteristics of Clostridium difficile isolates from foals with diarrhea and identify clinical abnormalities in affected foals. Methods: Retrospective study. Methods: 28 foals with C difficile-associated diarrhea. Methods: Toxigenicity, molecular fingerprinting, and antibiotic susceptibility patterns were determined. Information on signalment, clinical findings, results of clinicopathologic testing, whether antimicrobials had been administered prior to development of diarrhea, and outcome was obtained from the medical records. Results: Twenty-three (82%) foals survived...
Pedrick TP, Moon PF, Ludders JW, Erb HN, Gleed RD.To describe the effects of tromethamine, a putative treatment for metabolic acidosis, and to compare its biochemical effects with those of sodium bicarbonate. Methods: Randomized intervention study with repeated measures. Methods: 16 healthy horses, 3 to 17 years old, weighing 391 to 684 kg. Methods: Ten horses received 3 mEq/kg tromethamine and six received 3 mEq/kg sodium bicarbonate. Samples of venous blood and cerebrospinal fluid (CSF) were collected at intervals before and after drug administration. Heart rate and breathing rate were also recorded at intervals. Results: Median standard ba...
Toribio RE, Bain FT, Mrad DR, Messer NT, Sellers RS, Hinchcliff KW.Three weak, recumbent neonatal foals with skin lesions, including a thin wooly coat, were born to mares being treated for equine protozoal myeloencephalitis. Mares received sulfadiazine or sulfamethoxazole-trimethoprim, pyrimethamine, folic acid, and vitamin E orally. Foals were anemic, leukopenic, azotemic, hyponatremic, and hyperkalemic. Serum folate concentrations in the 3 foals and 2 mares were lower than those reported in the literature for clinically normal brood mares. Treatment was unsuccessful. For each foal, necropsy revealed lobulated kidneys with thin cortices and a pale medulla, a...
Geor RJ, Lund EM, Weiss DJ.Retrospective review of CBC and serum chemical data from 124 horses admitted to the veterinary teaching hospital over a 9-month period (Feb 1, 1990 to Oct 31, 1990) indicated that 54 horses had echinocytosis (prevalence = 44%). In horses with echinocytosis, the most frequent diagnosis was colitis (23 horses; 43%). Odds ratios (measure of association) were calculated to determine the association of echinocytosis with specific hematologic and biochemical abnormalities. When evaluated in a multivariate model, low serum sodium concentration (< 136 mEq/L) was the only variable significantly associa...
Lakritz J, Madigan J, Carlson GP.Hypovolemic hyponatremia attributable to severe fluid and electrolyte alterations was diagnosed in a foal with diarrhea. Subsequent consumption of water resulted in rapid reduction of serum sodium concentration and serum osmolar depression. Clinical signs of neurologic disease developed including blindness, loss of menace response, and seizures. Treatment of this condition with IV administered fluids included hypertonic saline solution (7.2%; 2 ml/kg of body weight), and frequent monitoring of serum electrolyte concentrations and osmolality resulted in gradual correction of the fluid and elect...
Mogg TD, Groenendyk S, Sutton RH.A 7-years-old Clydesdale mare was presented with severe abdominal distension and acute colic. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed. A 180 degrees volvulus of the pelvic flexure was present, associated with an inelastic band of tissue connecting the mesocolon to the umbilicus. The band was ligated and transected, and the volvulus reduced. Postoperative complications included hyponatraemia, metabolic acidosis and laminitis. The possible aetiology of the mesocolic-umbilical band is discussed.
Baerveldt MC, Klein WR.It is well documented that the incidence of rupture of the urinary bladder or urachus is highest in newborn male foals and occurs during the (usually uncomplicated) parturition. Important clinical symptoms include frequent passing of small quantities of urine, abdominal distention and positive abdominal undulation. Hyperkalaemia, hyponatraemia, hypochloraemia and an elevated serum creatinine level are often present. The serum blood urea nitrogen concentration may be normal or only slightly elevated. The creatinine concentration in the peritoneal fluid is invariably higher than that in serum, a...
Divers TJ, Whitlock RH, Byars TD, Leitch M, Crowell WA.Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses t...
Genetzky RM, Hagemoser WA.Two mature horses were examined for changes in laboratory and physical findings after experimentally induced bladder rupture. The postrupture laboratory diagnostic changes, which provide valuable information for a correct diagnosis are described. Hematology, serum and peritoneal fluid sodium, potassium, calcium, phosphorous, creatinine, urea nitrogen, albumin and peritoneal fluid components were measured and evaluated versus time. Hyponatremia and hyperkalemia occurred, as well as increased concentrations of peritoneal fluid potassium and inorganic phosphorus. In addition, peritoneal fluid cre...
Behr MJ, Hackett RP, Bentinck-Smith J, Hillman RB, King JM, Tennant BC.Rupture of the urinary bladder was diagnosed in 4 neonatal male foals. Marked hyponatremia, hypochloremia, and hyperkalemia developed in all 4 cases, and the electrolyte abnormalities were considered to be of potential diagnostic value. Blood urea nitrogen concentration was normal or only slightly higher than normal in 3 of 4 cases and therefore was not a reliable diagnostic test.
Magdesian KG, Hirsh DC, Jang SS, Hansen LM, Madigan JE.To determine molecular characteristics of Clostridium difficile isolates from foals with diarrhea and identify clinical abnormalities in affected foals. Methods: Retrospective study. Methods: 28 foals with C difficile-associated diarrhea. Methods: Toxigenicity, molecular fingerprinting, and antibiotic susceptibility patterns were determined. Information on signalment, clinical findings, results of clinicopathologic testing, whether antimicrobials had been administered prior to development of diarrhea, and outcome was obtained from the medical records. Results: Twenty-three (82%) foals survived...
Dunkel B, Palmer JE, Olson KN, Boston RC, Wilkins PA.Foals may present to a referral hospital with the primary diagnosis of uroperitoneum (UP), or they may develop UP while hospitalized for other reasons. Historical, physical, laboratory, and diagnostic variables of foals presenting with UP were compared to those developing UP while hospitalized. Emphasis was placed on the presence of electrolyte abnormalities, evidence of sepsis or infection, and development of anesthetic complications during surgical correction of the defect. Foals developing UP while in the hospital frequently had a history of dystocia and presented at a very young age (< ...
Behr MJ, Hackett RP, Bentinck-Smith J, Hillman RB, King JM, Tennant BC.Rupture of the urinary bladder was diagnosed in 4 neonatal male foals. Marked hyponatremia, hypochloremia, and hyperkalemia developed in all 4 cases, and the electrolyte abnormalities were considered to be of potential diagnostic value. Blood urea nitrogen concentration was normal or only slightly higher than normal in 3 of 4 cases and therefore was not a reliable diagnostic test.
Divers TJ, Whitlock RH, Byars TD, Leitch M, Crowell WA.Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses t...
Lakritz J, Madigan J, Carlson GP.Hypovolemic hyponatremia attributable to severe fluid and electrolyte alterations was diagnosed in a foal with diarrhea. Subsequent consumption of water resulted in rapid reduction of serum sodium concentration and serum osmolar depression. Clinical signs of neurologic disease developed including blindness, loss of menace response, and seizures. Treatment of this condition with IV administered fluids included hypertonic saline solution (7.2%; 2 ml/kg of body weight), and frequent monitoring of serum electrolyte concentrations and osmolality resulted in gradual correction of the fluid and elect...
Collins NM, Axon JE, Carrick JB, Russell CM, Palmer JE.To evaluate severe hyponatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) in order to determine the prevalence, clinical findings, primary diagnosis and outcome. Methods: Retrospective case study of records from Thoroughbred foals aged less than 3 months presenting to an ICU as medical emergencies in 2002-12; foals with severe hyponatraemia (serum sodium <122 mmol/L) on admission laboratory data were identified. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis, treatment and outcome. Results: Severe hyponatraemia w...
Toribio RE, Bain FT, Mrad DR, Messer NT, Sellers RS, Hinchcliff KW.Three weak, recumbent neonatal foals with skin lesions, including a thin wooly coat, were born to mares being treated for equine protozoal myeloencephalitis. Mares received sulfadiazine or sulfamethoxazole-trimethoprim, pyrimethamine, folic acid, and vitamin E orally. Foals were anemic, leukopenic, azotemic, hyponatremic, and hyperkalemic. Serum folate concentrations in the 3 foals and 2 mares were lower than those reported in the literature for clinically normal brood mares. Treatment was unsuccessful. For each foal, necropsy revealed lobulated kidneys with thin cortices and a pale medulla, a...
Mogg TD, Groenendyk S, Sutton RH.A 7-years-old Clydesdale mare was presented with severe abdominal distension and acute colic. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed. A 180 degrees volvulus of the pelvic flexure was present, associated with an inelastic band of tissue connecting the mesocolon to the umbilicus. The band was ligated and transected, and the volvulus reduced. Postoperative complications included hyponatraemia, metabolic acidosis and laminitis. The possible aetiology of the mesocolic-umbilical band is discussed.
Migliorisi A, Barger A, Austin S, Foreman JH, Wilkins P.Hyponatremia is common in horses with bacterial pleuropneumonia, but no further characterization of this abnormality has been reported. Objective: Describe admission plasma sodium concentration ([Na]) in horses with septic pneumopathy and evaluate any association of plasma [Na] with markers of systemic inflammation. Methods: Medical records of horses >1 month of age that between 2008 and 2021 had a transtracheal aspirate (TTA) performed, abnormal TTA cytology, positive TTA culture, pulmonary disease on ultrasonography, radiography or both, and plasma [Na] assessed by direct ion-selective-e...
Hardefeldt LY.Four neonatal foals were presented, over a 2-year period, (2011-2012) with aimlessly walking, head pressing, 'chewing gum' seizures and ataxia. The neurological lesion was consistent with increased intracranial pressure in all cases. All foals had severe hyponatraemia and azotaemia identified on biochemistry. Hyponatraemia was transient in 3/4 cases, with the foal in the final case requiring long-term sodium supplementation. Three foals survived to hospital discharge; one was euthanased because of anuric renal failure and one of the surviving foals was euthanased with septic osteomyelitis 2 we...
Pedrick TP, Moon PF, Ludders JW, Erb HN, Gleed RD.To describe the effects of tromethamine, a putative treatment for metabolic acidosis, and to compare its biochemical effects with those of sodium bicarbonate. Methods: Randomized intervention study with repeated measures. Methods: 16 healthy horses, 3 to 17 years old, weighing 391 to 684 kg. Methods: Ten horses received 3 mEq/kg tromethamine and six received 3 mEq/kg sodium bicarbonate. Samples of venous blood and cerebrospinal fluid (CSF) were collected at intervals before and after drug administration. Heart rate and breathing rate were also recorded at intervals. Results: Median standard ba...
Baerveldt MC, Klein WR.It is well documented that the incidence of rupture of the urinary bladder or urachus is highest in newborn male foals and occurs during the (usually uncomplicated) parturition. Important clinical symptoms include frequent passing of small quantities of urine, abdominal distention and positive abdominal undulation. Hyperkalaemia, hyponatraemia, hypochloraemia and an elevated serum creatinine level are often present. The serum blood urea nitrogen concentration may be normal or only slightly elevated. The creatinine concentration in the peritoneal fluid is invariably higher than that in serum, a...
Mullen KR.This article overviews metabolic disorders associated with renal disease. Included is a discussion of the pathophysiology, clinical signs, and treatment of hyperchloremic metabolic acidosis associated with renal tubular acidosis. Conditions affecting the central nervous system including uremic encephalopathy and hyponatremic encephalopathy secondary to renal disease are presented. Finally, a discussion of the unique features of calcium and phosphorus homeostasis in horses is provided with special emphasis on a recently described syndrome of calcinosis and calciphylaxis of unknown etiology.
Geor RJ, Lund EM, Weiss DJ.Retrospective review of CBC and serum chemical data from 124 horses admitted to the veterinary teaching hospital over a 9-month period (Feb 1, 1990 to Oct 31, 1990) indicated that 54 horses had echinocytosis (prevalence = 44%). In horses with echinocytosis, the most frequent diagnosis was colitis (23 horses; 43%). Odds ratios (measure of association) were calculated to determine the association of echinocytosis with specific hematologic and biochemical abnormalities. When evaluated in a multivariate model, low serum sodium concentration (< 136 mEq/L) was the only variable significantly associa...
Genetzky RM, Hagemoser WA.Two mature horses were examined for changes in laboratory and physical findings after experimentally induced bladder rupture. The postrupture laboratory diagnostic changes, which provide valuable information for a correct diagnosis are described. Hematology, serum and peritoneal fluid sodium, potassium, calcium, phosphorous, creatinine, urea nitrogen, albumin and peritoneal fluid components were measured and evaluated versus time. Hyponatremia and hyperkalemia occurred, as well as increased concentrations of peritoneal fluid potassium and inorganic phosphorus. In addition, peritoneal fluid cre...
Ferlini Agne G, Kapusniak AE, Wooldridge AA, Jung SW.In this case report, a high dose of torsemide (6mg/kg, every 12 hours for 3 days followed by 12mg/kg, every 12 hours for 4 days) was administered orally to a horse with congestive heart failure (CHF) and atrial fibrillation. Blood samples for measurement of plasma torsemide concentrations were obtained one hour after each drug administration. Pharmacodynamic effects of oral torsemide were evaluated by daily physical examination, electrocardiography, and serum biochemistry. The horse tolerated administration of torsemide. A decrease in ventral oedema and venous congestion was subjectively noted...
