SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
should be maintained on isotonic NaCl or balanced electrolytes (up to 80 mg/kg per
day IV) until there is a marked reduction in the severity of the azotemia.
Maintenance fluid therapy is then maintained until the animal is eating and drinking
adequately. After discontinuation of fluid therapy, SUN and/or Cr concentration
should be monitored every 3-4 days until the ultimate status of the animal can be
determined. Horses are usually polyuric during the period of tubular regeneration.
This condition gradually dissipates if sufficient healing occurs to enable renal
function to become normal. Meaning that the ability to concentrate urine returns.
Otherwise CRF ensues and the patient’s condition gradually declines.
Care must be exercised in selecting medications to be used in treating co-existing
conditions. This applies particularly to the use of potentially nephrotoxic antibiotics
and non-steroidal anti-inflammatory drugs. Bacteriostatic antibiotics with long half-
lives should have the dosing interval increased, while bacteriocidal antibiotics which
generally have short half-lives should be given in lower doses. Problems associated
with NSAID administration could be minimized by reducing the dose and ensuring
that the patient is properly hydrated.
CHRONIC RENAL FAILURE
Cases of chronic failure (CRF) can occur without being preceded by an apparent
episode of ARF, as with most cases of glomerulonephritis, and many toxic
nephropathies. CRF is nearly always progressive. As the number of functional
nephrons decreases, acute exacerbations (i.e. periods of oliguria) become more
frequent and harder to treat, until the horse finally dies, or euthanasia is performed.
History and Physical Examination
Weight loss is common in CRF. Anorexia and depression are related to the severity
of azotemia.
Pitting edema secondary to hypoalbuminemia accompanies
glomerulonephritis. Polyuria and polydypsia are common in CRF although they are
not always detected. Daily water consumption and urine output of healthy adult
horses is subject to considerable seasonal variation. Normal water intake is 15-80
L/day while average urinary output is 4-16 L/day.
With CRF, the kidneys may be reduced in size, in which case palpation of the left
kidney may be difficult. It may feel firmer than usual and have an irregular rather
than smooth surface.
Laboratory Evaluation
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