This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Urinary System » Kidney Disease and Failure in the Horse »
  Discussion on Possible Kidney Disease
Author Message

Posted on Tuesday, Jun 19, 2001 - 1:51 am:

I have a 13yr. pony mare that has the vet and I baffled. In Aug. 2000 she came down with a respitory problem. The vet said it was due to dusty hay. We put her on antibiotics and switched from alfalfa to bermuda hay. That cleared up. Then in Sept. I went out and found a large amount of blood clots in her pen. She was then treated for a UTI. 2 months later, more blood, again treated for UTI. In January she started being incontinent. She drinks large amounts of water and at times will urinate 3+ times in 15 minutes. About once a month I find large amounts of blood in her corral, but her urine looks clear. 2 months ago, we did bloodwork and urine test. The vet said she is borderline kidney disease. He also said it could possibly be a tumor, stone,herpes virus, or neurological disorder. He wanted to come back and do a water deprivation test but as of yet it has not been done. Her labs were as follows:

BUN-9
CREATININE-1.1
TRYGLYCERIDE:248
MCHC:39
All others normal

Urine: straw, hazy
Specific gravity-1.009
PH-8.0
occult blood-4+
WBC- 1-3
RBC- 10
Crystals/HPF
Calcium Carbonate +3
Epith cells/HPF
Squamous cells 3-5
All else normal

The last few days I am wondering if she is having eyesight problems, she now spooks sometimes when I walk up to her.

Does this look like possible kidney disease to you? I have searched the net for hours on end and I have not been able to find anything that fits her symptoms, let alone a prognosis. Other than the bleeding and urination, she is fine and healthy. She has a good appetite, her weight and coat look good and she is active. Any incite you could give me would be greatly appreciated!

Posted on Tuesday, Jun 19, 2001 - 1:55 am:

I also forgot to put that at times her heart rate is very elevated even though she hasn't been active. Thanks again!

Posted on Tuesday, Jun 19, 2001 - 2:17 am:

I had a friend with a horse who urinated in a similar pattern, and that horse turned out to have diabetes... going on human symptoms, that would tie in with your mare's eyesight problems.

I cannot remember the bloods for that horse, but it is worth mentioning to your vet, so that it can be ruled out/in.

Posted on Tuesday, Jun 19, 2001 - 2:22 am:

Thanks Heidi! That is one illness I haven't checked into yet! My vet is at a loss, he has been in practice for 20+ years and this is the first case hes seen like this. We are in a pretty rural area, so second opinions are hard to come by.

Posted on Wednesday, Jun 20, 2001 - 8:07 am:

Hello Richele,
If I understand your post correctly it is still uncertain where the large clots of blood are coming from?

I would like to see the lab test results that had normal values before I comment on your questions. DrO

Posted on Wednesday, Jun 20, 2001 - 9:36 pm:

Thankyou for responding Dr. O! Yes, that is correct, we DO NOT know where the blood is coming from. Even though she has passed large amounts, several times, I have not witnessed it while it happens and when I check her I can't see any traces on her vulva or rectum. In the last 2 days she has become totally incontinent. Urine is dripping constantly and she is soaked from the top of the tail down.

The labs were as follows:

AST (SGOT)- 295
ALT (SGPT)- 8
T. BILIRUBIN- 0.8

ALK PHOS- 134
GGT- 15
TOTAL PROTEIN- 7.0
ALBUMIN- 3.3
GLOBULIN- 3.7
A/G RATIO- 0.9
CHOLESTEROL- 104
BUN- 9 (L)
CREATININE- 1.1 (L)
BUN/CREAT RATIO- 8
PHOSPHORUS- 3.0
CALCIUM- 12.3

CALCIUM/PO4 RATIO- 4.1
CLUCOSE- 91
SODIUM- 135
POTASSIUM- 5.0
NA/K RATIO- 27
CHLORIDE- 100
CPK- 275
TRIGLYCERIDE- 248 (H)
OSMOLALITY, CALCULATED- 278

COMPLETE BLOOD COUNT
WBC- 8.1
RBC- 7.9
HGB- 15.5
PCV- 40
MCV- 51
MCH- 19.6
MCHC- 39 (H)
RBC MORPHOLOGY- NORMAL
NEUTROPHILS- 54
ABSOLUTE- 4374
LYMPHOCYTES- 41
ABSOLUTE- 3321
MONOCYTES- 4
ABSOLUTE- 324
EOSINOPHILS- 1
ABSOLUTE- 01
BASOPHILS- 0
ABSOLUTE- 0
PLATELET ESTIMATE- ADEQUATE
FIBRINOGEN SEMI-QUANT/HEAT PRECIP
175. FIBRINOGEN SEMI-QUANTITATIVE- 250

ADD-ON URINALYSIS
COLOR- STRAW
APPEARANCE- HAZY
SPECIFIC GRAVITY- 1.009
PH- 8.0
PROTEIN (ACID PPT)- NEGATIVE
GLUCOSE-STRIP- NEGATIVE
KETONES- NEGATIVE
BILIRUBIN- NEGATIVE
OCCULT BLOOD- 4+
WBC/HPF- 1-3
RBC/HPF- 3-10
CASTS/LPF- NONE OBSERVED
CRYSTALS/HPF
CALCIUM CARBONATE +3
EPITH CELLS/HPF
SQUAMOUS CELLS 3-5
BACTERIA- NONE OBSERVED
QUANTITATIVE PLATELET- 182

I hope this helps. Thankyou in advance.

Posted on Thursday, Jun 21, 2001 - 8:31 am:

On first run through these all look pretty normal, including some of the kidney function tests. The one abnormality that sticks out is that the urine is showing no concentration but this may not be the kidneys fault since the horse is drinking so much. The way to determine this is exactly what your vet has proposed: a water deprivation test to see if the kidneys begin concentrating. There are three possibilities I come up with off the top of my head:
1) the horse is simply drinking too much water (reason unknown),
2) kidneys are unable to concentrate because of reversible reasons (medullary washout or acute tubular disease)
3) kidneys are unable to concentrate because of irreversible disease (chronic tubular disease)

The first step in diagnosis and treatment if it is medullary wash out is to deprive the horse of water while monitoring hydration and see if the horse begins to concentrate. I have part of an article around here on this problem and I will see if I can get it finished by the first of next week.
DrO

Posted on Thursday, Jun 21, 2001 - 1:25 pm:

Thankyou again...I will get the water deprivation test as soon as the vet can get out again. Where do you think all the blood is coming from? I talked to the vet 2 days ago and asked about possible outcomes, whatever the cause. He said she will not die, we will just have a leaky pony. She cannot continue on like this though, her rear is just soaked with urine and it is near impossible to keep her clean. Now the bees are bothering her where shes wet all the time. The vet said there are some different medications, but they are very expensive and using them is out of the question. Aside from all that, I have hundreds of dollars in vet bills, a pony that is getting worse and still don't have any clue as to what to do for her.

If its medullary wash out or tubular disease, what are our treatment options and what will her future of usability be? She is my daughters gymkhana pony and I would like to know if theres any hope of her being ridable again so we can determine if we should get another pony or not.
Thanks again and I am forever grateful for your help:0)

Posted on Friday, Jun 22, 2001 - 7:53 am:

I am unsure where the blood is coming from. Use vaseline or Desitin to protect the horses skin. For tubular disease see the article on Acute Kidney Disease. I will cover the treatment for washout in the article, but it is important to know it is easily treatable.
DrO

Posted on Tuesday, Jun 26, 2001 - 7:54 pm:

Hello Richele,
The article is up at, Equine Diseases: Urinary System: Excessive Drinking and Urination, Polydipsia / Polyuria (PD/PU) and it should answer most your questions.
DrO

Posted on Wednesday, Jun 27, 2001 - 12:19 am:

Thankyou Dr.O. I will check it out and let you know the outcome of the water deprivation test.

Posted on Wednesday, Jun 27, 2001 - 8:59 am:

Just found this online pdf article, the original appeared in Equine Veterinary Education, Dec 2000.

Dr Knottenbelt discusses mechanism of water uptake and excretion, and it might provide some useful background information.

https://www.evj.co.uk/archive/EVE00_12_179_186.pdf
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC