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Veterinary
Urology

Chronic kidney disease in adult horses: causes, diagnosis and management

02 September 2021
Clinical
17 mins read
02 September 2021
Volume 5 · Issue 5
Figure 1. Ventral oedema.
Figure 1. Ventral oedema.

Abstract

Chronic kidney disease is a rare disease in horses, unlike humans and companion animals where it is frequently encountered. There are multiple causes, although, since the disease typically presents late in the disease process, the instigating factor is often not ascertained. Clinical signs most commonly include weight loss, ventral oedema and polyuria-polydipsia. There is a need for more sensitive markers of renal damage or dysfunction so that the disease can be detected earlier in its course. Serum symmetric dimethylarginine and neutrophil gelatinase-associated lipocalin are potential biomarkers that are being investigated in this regard. Currently, once the diagnosis has been made, treatment is supportive only, with no options to halt the progression of the disease. Although this is a terminal condition, horses can be maintained with an adequate quality of life for several years after diagnosis in some cases.

Chronic kidney disease in horses is a rare diagnosis, with one study finding a prevalence of 0.12% in a hospitalised population, increasing to 0.23% in horses over the age of 15 (Reed et al, 2018). This is far lower than in companion animals, where the overall prevalence is reported to be 0.9% in dogs and 1.6% in cats (Reed et al, 2018). However, the prevalence in horses is likely underestimated as many older horses presenting to the ambulatory veterinarian will be euthanased without a specific diagnosis or referral to a hospital.

Chronic kidney disease is a progressive, terminal condition. The aim is to detect abnormalities as early as possible in the disease process and, with appropriate management strategies, maintain an acceptable quality of life until the point at which euthanasia is required on humane grounds. The rate of progression cannot accurately be predicted, as survival following diagnosis can vary from several months to over 2 years (Schott, 2018).

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renal
weight loss
ventral oedema
symmetric dimethylarginine
neutrophil gelatinase-associated lipocalin