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Kidney Disease??? :(

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  • Kidney Disease??? :(

    Okay - I need some help here - any suggestions would be greatly appreciated.

    My 23 yr old thoroughbred mare is showing signs of kidney issues. Her bloodwork came back with high calcium, high phosphorus, high creatinine, and low red blood count. Her urinalysis came back showing that she is not concentrating her urine. We did a second test on the urine, just to see. I should get the results later today hopefully. We are also treating for ulcers as she has gone off her feed (and she is a very high strung and agitated mare at the best of times). She is getting omeprazole and sucalfrate (sp?) for the ulcers.

    If the ulcer meds do not help her re-gain her appetite, the vet said he will refer me to Guelph to get her kidneys ultrasounded. I should add that this mare looks more like a 12 year old! She is in a good weight, shiny coat, bright eyes. And aside from the grumpiness, she has lots of energy and seems pretty much normal - except that she is being extremely picky about eating right now.

    So, what can I do to help slow down the kidney problem? Anything? Is there something diet-wise I should do - or not do?

    There is a lady at my barn who is a doctor and a kidney specialist to boot (for people though) and she said nutrition is so important right now for my old girl. She was explaining to me why the calcium and phosphorus are high - and that I have to make sure the diet is LOW in potassium and phosphates. I asked about if the diet should also be a low protein, and she said that the low protein is not as important as the other two. However, I know with small animals they go to a low protein diet.

    Anyone have any suggestions? What food to feed? What not to feed? Any supplements that would be helpful?

    As well, would you still ride a horse with kidney troubles?
    http://www.hammerdownfarm.com

  • #2
    I lost a beautiful three year old filly to Kidney disease in 2003. It broke my heart, I had delivered her myself. She spent two weeks in the hospital, and another 10 days at home. If the loss of protein through the kidney cant' be stopped and if the kidney is failing, you may spend alot of money and still lose your horse, it is very devastating.

    My heart goes out to you, as I know how terribly sad this is. When the vets at the hospital told me that they had tried everything and the end was coming, it was too unbearable to take.

    Best wishes.
    http://www.herselffarm.com
    Proud of my Hunter Breeding Princesses
    "Grief is the price we all pay for love," Gretchen Jackson (1/29/07) In Memory of Barbaro

    Comment

    • Original Poster

      #3
      UPDATE on second urine test

      Well, a week after the first test, she is still not concentrating her urine, however now there are white cells in the sample - there were none last time. So the vet said to put her on some penicillin - maybe she has an infection? But I don't think an infection would explain the other levels being out of whack.... would it???
      http://www.hammerdownfarm.com

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      • #4
        Yes it could, don't ask me how I just know it happened to me. (myself I mean!) My horse has been having similar symptoms and we sent off blood today. I pray it isn't the kidneys.
        Every mighty oak was once a nut that stood its ground.

        Proud Closet Canterer! Member Riders with Fibromyalgia clique.

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        • #5
          I'm no expert, but kidney issues can be the result of an infection. I would ask your vet to forward everything to a specialist for a 2nd opinion. Without signs of dehydration and azotemia (increased BUN and Creatnine) I'm not sure if everyone would call it kidney failure.

          I say this because when we had a horse in true renal failure, the drug of choice (in the barn) would have been SMZ's, not Penicillin. In the hospital I beleive we used Baytril. We also did intense fluid therapy. This was an acute case, however, not chronic.

          On an odd note, did you culture the urine to see if there was a UTI?

          Our horse that was in acute renal failure is doing very well. There is hope. Lots of it I wish you the best of luck with your older mare. Don't hesitate to get a 2nd (or maybe 3rd) opinion, even sending the blood work/urinalysis out of state to someone else. PM LarkspurCO for an interesting recent story about how a prognosis can vary from one horse to another.

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          • Original Poster

            #6
            Originally posted by FatPalomino View Post
            I'm no expert, but kidney issues can be the result of an infection. I would ask your vet to forward everything to a specialist for a 2nd opinion. Without signs of dehydration and azotemia (increased BUN and Creatnine) I'm not sure if everyone would call it kidney failure.

            I say this because when we had a horse in true renal failure, the drug of choice (in the barn) would have been SMZ's, not Penicillin. In the hospital I beleive we used Baytril. We also did intense fluid therapy. This was an acute case, however, not chronic.

            On an odd note, did you culture the urine to see if there was a UTI?

            Our horse that was in acute renal failure is doing very well. There is hope. Lots of it I wish you the best of luck with your older mare. Don't hesitate to get a 2nd (or maybe 3rd) opinion, even sending the blood work/urinalysis out of state to someone else. PM LarkspurCO for an interesting recent story about how a prognosis can vary from one horse to another.
            Now, I am not absolutely sure, but the vet may have suggested penicillin because this horse has had EPM as well in the past - and apparently you do not give a horse any kind of steroid type drug once they have had EPM. Or at least that's what my vet says. I have no idea if SMZ's are a type of steroid or not - but I do know that we have had to be very careful about giving her certain meds in the past.

            I love my vet, but I am wondering if this may be beyond his speciality. He has already said that he will give me a referral to an equine hospital that is not too far away if I should want to pursue the kidneys - he has already stated that the next step would be an ultrasound and that I'd be better off going to the other place for that.

            In the mean time though, we are trying the penicillin and another kidney flush - and then we will re-test the urine in a while and see. She did have increased Creatinine in the bloodwork results.
            http://www.hammerdownfarm.com

            Comment


            • #7
              I'm so sorry you and your mare are going through this. Kidney disease is tough in horses because we don't have nearly as many options as we do in dogs and cats.

              How long has this been going on? What signs was your mare showing that made you and your vet concerned in the first place? Did this come on suddenly, or has she had a slowly decreasing appetite? Have you noticed a change in her body condition or coat condition? Was her BUN elevated as well, or just Creatinine?

              SMZ is a different type of antibiotic. Did your vet see bacteria in her urine or just white blood cells? Did he culture her urine? Urinary tract infections in horses are rarely a primary problem like they are in small animals; they are usually second to another problem in the urinary tract.

              In my opinion, I would have your vet call the University and talk to an internal medicine specialist now. Let the internal medicine specialist decide if they want to see her ASAP or if they're comfortable waiting to see what happens with the antibiotics.

              ***Disclaimer: I'm still a veterinary student, not a vet, so please rely on medical information given to you by veterinarians who can physically see and evaluate your horse. That's always a better way to go than relying on advice given to you over the internet when the people you're talking to have variable experience and don't have the complete picture of what's going on with your horse.

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              • Original Poster

                #8
                Originally posted by In The Gate View Post
                I'm so sorry you and your mare are going through this. Kidney disease is tough in horses because we don't have nearly as many options as we do in dogs and cats.

                How long has this been going on? What signs was your mare showing that made you and your vet concerned in the first place? Did this come on suddenly, or has she had a slowly decreasing appetite? Have you noticed a change in her body condition or coat condition? Was her BUN elevated as well, or just Creatinine?

                SMZ is a different type of antibiotic. Did your vet see bacteria in her urine or just white blood cells? Did he culture her urine? Urinary tract infections in horses are rarely a primary problem like they are in small animals; they are usually second to another problem in the urinary tract.

                In my opinion, I would have your vet call the University and talk to an internal medicine specialist now. Let the internal medicine specialist decide if they want to see her ASAP or if they're comfortable waiting to see what happens with the antibiotics.

                ***Disclaimer: I'm still a veterinary student, not a vet, so please rely on medical information given to you by veterinarians who can physically see and evaluate your horse. That's always a better way to go than relying on advice given to you over the internet when the people you're talking to have variable experience and don't have the complete picture of what's going on with your horse.
                Hi and thanks for your response. I am not sure what BUN stands for, and I am still waiting for the office to send me the results of my mare's bloodwork so I have a copy as well, but I do know that the creatinine, calcium, and phosphorus were all high, and the red count was low.

                I have the urine results here (however I have no idea what it all means) but my vet said the second test from November 4th showed white cells, but the test from October 21st did not. The only other thing he said it showed was that she is not concentrating her urine in either test.

                So far her body condition and coat have not changed. She is still in a fairly good weight at this time. The reason I had him out in the first place is that this mare just started to eat less and less food. And drink more and more. And pee A LOT. At least that's what the barn staff are saying - her stall is one of the wettest now..... and she never used to be THAT messy. It was getting to the point where she was barely touching her hay - leaving most if not all of her grain (and we were trying different types, concoctions, everything). So, even though she wasn't losing weight, I knew that if she didn't start eating again she would lose weight as well. And she is a hard-keeper to begin with. Now, since she has been on the ulcer meds, she is eating again. Still not totally back to normal, but much better than before.

                Also, when she is turned out, she will graze for a while, and then go stand by the water trough for fairly long periods of time, just sipping water on and off while standing there. Now, once again, since being on the meds, she is grazing more and standing by the water less. So - my vet was hoping that it was possibly something as simple as ulcers. And a kidney infection? I don't know...
                http://www.hammerdownfarm.com

                Comment


                • #9
                  Mine does that too (the water trough thing). I never thought I'd be praying for ulcers but I am! I called the vet for results and he was busy so I'm still waiting. Jeez, mine is 23 too!
                  Every mighty oak was once a nut that stood its ground.

                  Proud Closet Canterer! Member Riders with Fibromyalgia clique.

                  Comment

                  • Original Poster

                    #10
                    Originally posted by summerhorse View Post
                    Mine does that too (the water trough thing). I never thought I'd be praying for ulcers but I am! I called the vet for results and he was busy so I'm still waiting. Jeez, mine is 23 too!
                    I know - here I am HOPING my horse has an ulcer..... how horrible is that??? But we can treat ulcers.... we really can't do anything for the kidneys once they start to go

                    Is your horse also not eating very well? Weight loss or anything??
                    http://www.hammerdownfarm.com

                    Comment


                    • #11
                      One of the common causes of drinking too much and peeing a lot in an older horse is Cushings disease.

                      In horses, the big rule outs for drinking a lot and peeing a lot (polyuria/polydipsia) are Cushings disease, kidney failure (acute or chronic), and something called psychogenic polyuria/polydipsia. (The exact cause of the last one is unknown, it may be related to boredom or disruption of the sensor in the brain that tells the horse when it is thirsty leading to excessive thirst. Restricting the water intake of these horses will show that they have normal urine concentrating ability, and the only treatment is to restrict water intake to just over what a normal horse would drink.) IV fluids can also cause a horse to pee a lot.

                      I personally haven't heard about ulcers causing PU/PD, but that doesn't mean it isn't a cause as well.

                      Comment

                      • Original Poster

                        #12
                        Originally posted by In The Gate View Post
                        One of the common causes of drinking too much and peeing a lot in an older horse is Cushings disease.

                        In horses, the big rule outs for drinking a lot and peeing a lot (polyuria/polydipsia) are Cushings disease, kidney failure (acute or chronic), and something called psychogenic polyuria/polydipsia. (The exact cause of the last one is unknown, it may be related to boredom or disruption of the sensor in the brain that tells the horse when it is thirsty leading to excessive thirst. Restricting the water intake of these horses will show that they have normal urine concentrating ability, and the only treatment is to restrict water intake to just over what a normal horse would drink.) IV fluids can also cause a horse to pee a lot.

                        I personally haven't heard about ulcers causing PU/PD, but that doesn't mean it isn't a cause as well.
                        Well, what are some other signs of kidney failure - whether it be acute or chronic? If you don't mind me asking - I really appreciate your insight into this
                        http://www.hammerdownfarm.com

                        Comment


                        • #13
                          Originally posted by Firefilly View Post
                          I am not sure what BUN stands for,
                          It stands for blood urea nitrogen. Elevated BUN and Creatinine usually suggest kidnet problems.

                          As someone else mentioned, SMZ's are a different type of antiobiotics, no steroids involved I was told by an internal medicine specialist that they are the antiobiotics of choice when treating a horse was an infection damaging the kidneys, which is not hospitalized.

                          I would second consulting an internal medicine specialist

                          I hope she feels better soon!

                          Comment


                          • #14
                            Unfortunately the signs of kidney disease are pretty non-specific. In acute kidney disease, you'd expect to see a horse acting sick; depression, anorexia, dehydration. You might see slight weight loss, but you wouldn't expect to see chronic weight loss or poor coat condition. The horse may either be drinking a lot of water and peeing a lot or not peeing at all (or in the middle).

                            In chronic renal failure, you'd expect to see a horse that has lost weight, is somewhat lethargic and has a poor coat condition. However, it's possible to not have a long history of a problem. You may see dental tartar because the horse has had a dry mouth. They will generally drink a lot and pee a lot. Anemia is common, either from decreased production of erythropoietin by the kidney (this is the hormone that promotes red blood cell production) or just due to the chronicity of the disease itself.

                            I know that isn't much help. You'll get a suspicion of kidney disease from a history and physical exam, but the diagnosis of kidney disease is really made on blood work, urinalysis and an ultrasound.

                            Comment

                            • Original Poster

                              #15
                              Originally posted by In The Gate View Post
                              You may see dental tartar because the horse has had a dry mouth.
                              What would dental tartar look like in a horse's mouth??
                              http://www.hammerdownfarm.com

                              Comment

                              • Original Poster

                                #16
                                Originally posted by FatPalomino View Post
                                It stands for blood urea nitrogen. Elevated BUN and Creatinine usually suggest kidnet problems.

                                As someone else mentioned, SMZ's are a different type of antiobiotics, no steroids involved I was told by an internal medicine specialist that they are the antiobiotics of choice when treating a horse was an infection damaging the kidneys, which is not hospitalized.

                                I would second consulting an internal medicine specialist

                                I hope she feels better soon!
                                I finally have her results in front of me now - and her BUN is right at the edge of being high. The normal range is 10 to 25 and she is 25. A year ago her BUN was 17. And her creatinine is 3 (normal is 0.8 to 2.2) and a year ago her creatinine was 1.8.

                                Her phosphorus is 5.7 (normal is 1.8 to 5.6) and a year ago she was 2.5.

                                And her calcium is pretty high unfortunately It is 14.7 (normal is 10.4 to 12.9) and a year ago she was 13.0.

                                What is really concerning me about this high calcium is that I hear its likely high because the parathyroid hormone is pulling it from her bones (and strangely enough she had a hairline fracture of her pastern bone just a few months ago - and unexplained injury at the time - we thought maybe she had gotten cast in her stall and it was self-inflicted... now I am very worried that these results might be telling us why she had a hairline fracture - which is all healed now, by the way.)
                                http://www.hammerdownfarm.com

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