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Gratwick Z. An updated review: Laboratory investigation of equine renal disease. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Z. Gratwick
- Axiom Veterinary Laboratories Ltd Newton Abbot, Devon UK
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2
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Schott HC, Esser MM. The Sick Adult Horse: Renal Clinical Pathologic Testing and Urinalysis. Vet Clin North Am Equine Pract 2020; 36:121-134. [PMID: 32037140 DOI: 10.1016/j.cveq.2019.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Clinicopathologic evaluation of renal function and renal disease in sick adult horses remains grounded in detection of azotemia, assessment of serum and urine electrolyte concentrations, and evaluation of urinalysis findings, including specific gravity, reagent strip analysis, and sediment examination. Because increases in serum or plasma urea nitrogen and creatinine concentrations are insensitive indicators of a decreased glomerular filtration rate, there is considerable interest in identifying novel biomarkers of renal function or injury in blood and urine, with serum symmetric dimethylarginine concentration being the most recent addition to the commercial market.
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Affiliation(s)
- Harold C Schott
- Department of Large Animal Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, Room D-202, 736 Wilson Road, East Lansing, MI 48824, USA.
| | - Melissa M Esser
- Department of Large Animal Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, Room D-202, 736 Wilson Road, East Lansing, MI 48824, USA
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Bayless RL, Moore AR, Hassel DM, Byer BJ, Landolt GA, Nout-Lomas YS. Equine urinary N-acetyl-β-D-glucosaminidase assay validation and correlation with other markers of kidney injury. J Vet Diagn Invest 2019; 31:688-695. [PMID: 31347464 DOI: 10.1177/1040638719867124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Detection of equine acute kidney injury (AKI) is hindered by limited markers of early renal damage in horses. N-acetyl-β-D-glucosaminidase (NAG), a lysosomal enzyme in renal tubular epithelium released into urine during tubular insult, has shown promise for early identification of AKI in humans and other species. We validated an assay for NAG in equine urine and measured urinary NAG in 7 azotemic and 7 non-azotemic client-owned adult horses. The enzymatic NAG assay was validated using within- and between-run coefficients of variation (CVs), recovery following standard addition, and linearity of dilution. Intra- and inter-run CVs (21% and 3.2%, respectively), average recovery following standard addition (99-109%), and linearity under serial dilution (R2 = 0.997) were satisfactory. Urine NAG index was significantly correlated with urinary fractional excretion of sodium (FENa; ρ = 0.76, p < 0.001) and plasma creatinine (ρ = 0.74, p = 0.001). Median urine NAG indices were higher in azotemic horses (p = 0.006), in horses with increased urinary FENa (p = 0.006), and in horses with increased urine gamma-glutamyl transferase index (p = 0.032). Urine NAG can be measured in horses and shows positive correlation with 2 current renal biomarkers. Additional work is needed to establish normal equine reference intervals and characterize the increase of urine NAG index in horses in relation to tubular injury.
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Affiliation(s)
- Rosemary L Bayless
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC (Bayless).,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO (Moore, Hassel, Byer, Landolt, Nout-Lomas)
| | - A Russell Moore
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC (Bayless).,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO (Moore, Hassel, Byer, Landolt, Nout-Lomas)
| | - Diana M Hassel
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC (Bayless).,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO (Moore, Hassel, Byer, Landolt, Nout-Lomas)
| | - Brittney J Byer
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC (Bayless).,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO (Moore, Hassel, Byer, Landolt, Nout-Lomas)
| | - Gabriele A Landolt
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC (Bayless).,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO (Moore, Hassel, Byer, Landolt, Nout-Lomas)
| | - Yvette S Nout-Lomas
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC (Bayless).,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO (Moore, Hassel, Byer, Landolt, Nout-Lomas)
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Lester GD, Merritt AM, Kuck HV, Burrow JA. Systemic, renal, and colonic effects of intravenous and enteral rehydration in horses. J Vet Intern Med 2013; 27:554-66. [PMID: 23551797 DOI: 10.1111/jvim.12073] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 09/23/2012] [Accepted: 02/04/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Intravenous (IV) and intragastric (IG) administration of fluid therapy are commonly used in equine practice, but there are limited data on the systemic, renal, and enteric effects. HYPOTHESIS IV fluid administration will increase intestinal and fecal hydration in a rate-dependent manner after hypertonic dehydration, but will be associated with significant urinary water and electrolyte loss. Equivalent volumes of IG plain water will result in comparatively greater intestinal hydration with less renal loss. ANIMALS Six Thoroughbred geldings. METHODS Experimental study. 6 by 6 Latin square design investigating constant rate IV administration at 50, 100, and 150 mL/kg/d over 24 hours in horses dehydrated by water deprivation. Equivalent volumes of IG plain water were administered by 4 bolus doses over 24 hours. RESULTS Water deprivation resulted in a significant decrease in the percentage of fecal water, and increases in serum and urine osmolality. IV fluids administered at 100 and 150 mL/kg/d restored fecal hydration, but increasing the rate from 100 to 150 mL/kg/d did not confer any additional intestinal benefit, but did result in significantly greater urine production and sodium loss. Equivalent 24-hour volumes of plain water resulted in greater intestinal water and less urine output. CONCLUSIONS AND CLINICAL IMPORTANCE IV polyionic isotonic fluids can be used to hydrate intestinal contents in situations where enteral fluids are impractical. IV fluids administered at three times maintenance are no more efficacious and might be associated with adverse physiological findings after withdrawal. Bolus dosing of IG water can be used to restore intestinal water with minimal adverse effects.
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Affiliation(s)
- G D Lester
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA, Australia.
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Lefebvre HP, Dossin O, Trumel C, Braun JP. Fractional excretion tests: a critical review of methods and applications in domestic animals. Vet Clin Pathol 2008; 37:4-20. [PMID: 18366540 DOI: 10.1111/j.1939-165x.2008.00010.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The fractional excretion (FE) of a constituent by the kidney is the fraction of the amount filtered by the glomerulus, which is excreted into urine. It is mostly determined for electrolytes, and is expressed as the ratio of the clearance of a given electrolyte to creatinine clearance. The main physiologic factors affecting FE variation are species, age, and the alimentary supply of electrolytes. The value of FE tests in the diagnosis of kidney disease is limited, except in canine Fanconi's syndrome. FEs of many constituents often are increased in chronic kidney disease, but their diagnostic value is no greater than that of plasma creatinine concentration. FEs also are altered in nonrenal diseases such as diabetes mellitus and rhabdomyolysis, and during treatment with xylazine, rehydration fluids, and diuretics. FEs, especially of calcium, phosphates, and magnesium, are useful in clinical nutrition to assess mineral balance. FE is difficult to measure, so its use should be limited to nutritional investigations and nephrology research.
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Affiliation(s)
- Hervé P Lefebvre
- Département des Sciences Cliniques, Ecole Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, Toulouse Cedex 03, France.
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Groover ES, Woolums AR, Cole DJ, LeRoy BE. Risk factors associated with renal insufficiency in horses with primary gastrointestinal disease: 26 cases (2000-2003). J Am Vet Med Assoc 2006; 228:572-7. [PMID: 16478436 DOI: 10.2460/javma.228.4.572] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify factors associated with renal insufficiency in colic- or colitis-affected horses with high serum creatinine (SCr) concentrations evaluated at a referral hospital. DESIGN Retrospective case series. ANIMALS 167 colic- or colitis-affected horses (88 represented a random sample [hospital population], and 79 had high SCr concentration at initial evaluation [study population]). PROCEDURE Medical records were reviewed. Data collected included signalment; physical examination, clinicopathologic, and diagnostic findings; and outcome. The study population was categorized on the basis of whether SCr concentration did (AR group; n = 53) or did not (PA group; 26) normalize within 72 hours of fluid therapy. Characteristics of the study and hospital populations were compared. RESULTS Males and Quarter Horses were significantly overrepresented in the study population. Compared with the hospital population, study-population horses were significantly more likely to have colitis, gastric reflux, and diarrhea at initial evaluation. Initial mean SCr concentration in the PA group was significantly higher than the AR group; identification of gastric reflux, abnormal rectal examination findings, and hypochloremia were significantly associated with persistent azotemia after 72 hours of fluid therapy. Compared with the AR group, PA group horses were 3 times as likely to die or be euthanized. CONCLUSIONS AND CLINICAL RELEVANCE In colic- or colitis-affected horses, factors associated with renal insufficiency included gastric reflux, abnormal rectal examination findings, or hypochloremia initially; prognosis for horses in which azotemia resolves within 72 hours of treatment appears to be better than for horses with persistent azotemia.
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Affiliation(s)
- Erin S Groover
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30605, USA
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Buchanan BR, Sommardahl CS, Rohrbach BW, Andrews FM. Effect of a 24-hour infusion of an isotonic electrolyte replacement fluid on the renal clearance of electrolytes in healthy neonatal foals. J Am Vet Med Assoc 2005; 227:1123-9. [PMID: 16220674 DOI: 10.2460/javma.2005.227.1123] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of a 24-hour infusion of an isotonic electrolyte replacement fluid (IERF) on weight, serum and urine electrolyte concentrations, and other clinicopathologic variables in healthy neonatal foals. ANIMALS 4 healthy 4-day-old foals. DESIGN Prospective study. PROCEDURE An IERF was administered to each foal at an estimated rate of 80 mL/kg/d (36.4 mL/lb/d) for 24 hours. Body weight was measured before and after the infusion period. Urine was collected via catheter during 4-hour periods; blood samples were collected at 4-hour intervals. Variables including urine production; urine and serum osmolalities; sodium, potassium, and chloride concentrations in urine and serum; urine and serum creatinine concentrations; urine osmolality-to-serum osmolality ratio (OsmR); transtubular potassium gradient (TTKG); and percentage creatinine clearance (Cr(cl)) of electrolytes were recorded at 0, 4, 8, 12, 16, 20, and 24 hours during the infusion period. Immediately after the study period, net fluid and whole-body electrolyte changes from baseline values were calculated. RESULTS Compared with baseline values, urine and serum sodium and chloride serum concentrations, urine and serum osmolalities, OsmR, and percentage Cr(cl) of sodium and chloride were significantly increased at various time points during the infusion; urine production did not change significantly. After 24 hours, weight, TTKG, serum creatinine concentration, and whole-body potassium had significantly decreased from baseline values. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that administration of an IERF containing a physiologic concentration of sodium may not be appropriate for use in neonatal foals that require maintenance fluid therapy.
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Affiliation(s)
- Benjamin R Buchanan
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
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Toribio RE, Kohn CW, Chew DJ, Sams RA, Rosol TJ. Comparison of serum parathyroid hormone and ionized calcium and magnesium concentrations and fractional urinary clearance of calcium and phosphorus in healthy horses and horses with enterocolitis. Am J Vet Res 2001; 62:938-47. [PMID: 11400854 DOI: 10.2460/ajvr.2001.62.938] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate calcium balance and parathyroid gland function in healthy horses and horses with enterocolitis and compare results of an immunochemiluminometric assay (ICMA) with those of an immunoradiometric assay (IRMA) for determination of serum intact parathyroid hormone (PTH) concentrations in horses. ANIMALS 64 horses with enterocolitis and 62 healthy horses. PROCEDURES Blood and urine samples were collected for determination of serum total calcium, ionized calcium (Ca2+) and magnesium (Mg2+), phosphorus, BUN, total protein, creatinine, albumin, and PTH concentrations, venous blood gases, and fractional urinary clearance of calcium (FCa) and phosphorus (FP). Serum concentrations of PTH were measured in 40 horses by use of both the IRMA and ICMA. RESULTS Most (48/64; 75%) horses with enterocolitis had decreased serum total calcium, Ca2+, and Mg2+ concentrations and increased phosphorus concentrations, compared with healthy horses. Serum PTH concentration was increased in most (36/51; 70.6%) horses with hypocalcemia. In addition, FCa was significantly decreased and FP significantly increased in horses with enterocolitis, compared with healthy horses. Results of ICMA were in agreement with results of IRMA. CONCLUSIONS AND CLINICAL RELEVANCE Enterocolitis in horses is often associated with hypocalcemia; 79.7% of affected horses had ionized hypocalcemia. Because FCa was low, it is unlikely that renal calcium loss was the cause of hypocalcemia. Serum PTH concentrations varied in horses with enterocolitis and concomitant hypocalcemia. However, we believe low PTH concentration in some hypocalcemic horses may be the result of impaired parathyroid gland function.
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Affiliation(s)
- R E Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210, USA
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Stockham SL. Interpretation of equine serum biochemical profile results. Vet Clin North Am Equine Pract 1995; 11:391-414. [PMID: 8925417 DOI: 10.1016/s0749-0739(17)30307-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- S L Stockham
- Department of Veterinary Pathobiology, University of Missouri-Columbia, USA
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Mealey RH, Carter GK, Roussel AJ, Ruoff WW. Indwelling cecal catheters for fluid administration in ponies. J Vet Intern Med 1995; 9:347-52. [PMID: 8531182 DOI: 10.1111/j.1939-1676.1995.tb01096.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Two different fluid solutions were infused through percutaneous cecal catheters in 6 healthy ponies to determine the effects on body weight; CBC; packed cell volume (PCV); total plasma protein concentration; plasma fibrinogen concentration; abdominal fluid analysis; concentrations of blood urea nitrogen (BUN), serum creatinine, Ca, total CO2 (TCO2), Na, Cl, K, and P; and fractional clearance (FC) of Na, Cl, K, and P. During intracecal administration of solution 1, FCNa and FCCl were significantly increased, whereas FCK and BUN were significantly decreased. During administration of solution 2, FCNa and serum P were significantly increased, while PCV was significantly decreased. All ponies developed peritonitis during the study. Complications included catheter-related problems, diarrhea, laminitis, and hypocalcemia. We concluded that hydration and electrolyte balance could be maintained by administration of crystalloid solutions intracecally, but that complications were associated with the procedure.
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Affiliation(s)
- R H Mealey
- Department of Veterinary Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station 77843, USA
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