Uremic encephalopathy in a horse.

The research describes the first identified case of uremic encephalopathy (disorder of the brain function due to kidney failure) in a horse. It details the clinical signs of the disease, the treatment attempts, and post-mortem findings, underscoring unique forms of brain cell responses in this instance.

Presentation and Initial Diagnosis

• A 13-year-old mare was brought to the Cornell University College of Veterinary Medicine with symptoms including a progressive loss of appetite, lethargy, and unusual behaviour like irregular lying down, pressing its head against things and experiencing seizure-like activity.
• Previous treatments for an undetermined potential toxicity had not improved her condition. On examination, she was found to have signs of blindness, and although her temperature was normal, her heart rate was unusually high. She was also found to have a blockage in her small colon.
• Several illnesses were considered as potential causes of her symptoms including viral encephalitis, liver disease, lead poisoning, leukoencephalomalacia (a softening of white brain matter), cancer of the forebrain, kidney failure, and colon obstruction.

Further Tests and Findings

• Blood tests showed several abnormalities indicating potential infections or physiological unbalances like mild anemia, an excessive number of white blood cells, low levels of blood proteins (albumin and globulin), along with low levels of important electrolytes (potassium and chloride).
• Significantly, very high blood levels of urea and creatinine (indicative of compromised kidney function) were found. The cerebrospinal fluid, however, showed no unusual findings.
• Given the severity of the neurological symptoms and the colon blockage, the prognosis was poor and the owners opted to euthanize the animal.

Post-Mortem Examination

• The post-mortem examination revealed the kidneys were enlarged and pale, indicating the potential presence of kidney disease or damage.
• The findings highlight a unique instance of an aggressive response from astrocytes (cells in the central nervous system) in domestic animals suffering from uremic encephalopathy, contrary to other species.

This case report identifies the first known instance of uremic encephalopathy in a horse, adding to the understanding of the effects of kidney failure on the nervous system in different species.