Acute renal failure in six horses resulting from haemodynamic causes.

The research looked into acute renal failure in horses, resulting from haemodynamic causes. Six horses were hospitalized due to illnesses unrelated to renal failure, and hypotension and abnormal coagulation were common symptoms. They displayed high creatinine levels, low urine specific gravity, and electrolyte imbalances, with tubular necrosis and renal cortical necrosis seen in kidney examination. Intravenous fluid was a key treatment for non-oliguric horses, while drugs such as furosemide were used in oliguric cases.

Context and Objective

• This research aimed to investigate the occurrence of acute renal failure in horses, resulting from haemodynamic issues. Renal failure refers to the condition where the kidneys fail to adequately filter waste products from the blood. The haemodynamic cause points to abnormalities in the circulation of blood.
• The cases under study were six horses treated at a hospital for conditions not related to renal failure—diarrhoea, myositis, abdominal pain, or suspected bacterial sepsis.

Findings

• Frequent findings in the horses included hypotension, which is abnormally low blood pressure, and disseminated intravascular coagulopathy, a condition that affects the blood’s ability to clot.
• Abnormally high creatinine concentration, a waste product filtered by the kidneys, was a prominent sign of acute renal failure. As an additional indicator, a urine specific gravity of less than 1.022 was observed.
• Electrolyte imbalances were common, particularly lowered levels of sodium (hyponatraemia) and chloride (hypochloraemia) but hyperkalaemia (high potassium levels) was not seen.
• In terms of kidney damage, varying degrees of tubular necrosis (death of tissues in the tube-like structures in the kidneys) occurred in three horses, while renal cortical necrosis (destruction of the outer parts of the kidney) happened in one.

Treatment and Prognosis

• For the non-oliguric cases, i.e., those still producing a sufficient amount of urine, intravenous fluid and electrolyte replacement formed the most critical part of the therapy.
• Horses exhibiting oliguria (low urine output) were treated with medications, notably furosemide, mannitol and dopamine.
• The outcome generally seemed favorable as long as the underlying (predisposing) cause could be treated and if the acute kidney failure did not result in severe reduction of urine output (oliguria).