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van Galen G, Divers TJ, Savage V, Schott HC, Siwinska N. ECEIM consensus statement on equine kidney disease. J Vet Intern Med 2024; 38:2008-2025. [PMID: 38801172 PMCID: PMC11256176 DOI: 10.1111/jvim.17101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
The aim of this consensus statement is to summarize and appraise scientific evidence and combine this with the clinical experience of a panel of experts to optimize recommendations on how to recognize and manage kidney disease in horses.
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Affiliation(s)
- Gaby van Galen
- Goulburn Valley Equine HospitalCongupnaVictoriaAustralia
- Sydney School of Veterinary ScienceUniversity of SydneySydneyNew South WalesAustralia
| | - Thomas J. Divers
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
| | | | - Harold C. Schott
- College of Veterinary MedicineMichigan State UniversityEast LansingMichiganUSA
| | - Natalia Siwinska
- Faculty of Veterinary MedicineWroclaw University of Environmental and Life SciencesWroclawPoland
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Abstract
Polyuria and polydipsia are rare, but significant, manifestations of several different diseases of horses. Causes can be endocrine, iatrogenic, psychogenic, infectious, or toxic in nature and can also be due to primary renal disease or diseases of other organs, such as the liver. Although numerous causes of polyuria and polydipsia in horses exist, the most common conditions include chronic kidney disease, pituitary pars intermedia dysfunction, and psychogenic polydipsia with secondary polyuria. Additional testing is dictated by history, other clinical signs, and the results of blood work and/or urinalysis. Prognosis for horses with polyuria and/or polydipsia varies significantly based on the underlying cause.
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Durie I, Galen G. Long‐term hormone replacement treatment in a horse with central diabetes insipidus. Vet Med (Auckl) 2020; 34:1013-1017. [PMID: 31960998 PMCID: PMC7096602 DOI: 10.1111/jvim.15697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/20/2019] [Indexed: 11/28/2022]
Abstract
This case report describes the clinical presentation, and the diagnostic and therapeutic approaches of a 4‐year‐old gelding presented with severe polyuria and polydipsia. The horse was diagnosed with central diabetes insipidus. After diagnosis, different therapeutic regimens with intraocular desmopressin acetate (Minirin, Ferring GmbH, Kiel, Germany) (a synthetic arginine vasopressin analog) were tested, but without success. Only the subcutaneous injection of desmopressin acetate (Minirin, Ferring GmbH) led to an increase in urine specific gravity and a decrease in water intake and urine output. Daily subcutaneous treatment with desmopressin acetate (Minirin, Ferring GmbH) was initiated and maintained for at least 5 years. The horse did not develop adverse effects or re‐occurrence of the initial complaints. This case report describes successful long‐term treatment of central diabetes insipidus in a horse.
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Affiliation(s)
- Inge Durie
- Equine Referral Hospital, Evidensia Specialisthästsjukhuset Strömsholm Strömsholm Sweden
| | - Gaby Galen
- Veterinary Teaching Hospital of Camden, University of Sydney Sydney Australia
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Abstract
Equine endocrine disease is commonly encountered by equine practitioners. Pituitary pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS) predominate. The most logical therapeutic approach in PPID uses dopamine agonists; pergolide mesylate is the most common. Bromocryptine and cabergoline are alternative drugs with similar actions. Drugs from other classes have a poor evidence basis, although cyproheptadine and trilostane might be considered. EMS requires management changes as the primary approach; reasonable justification for use of drugs such as levothyroxine and metformin may apply. Therapeutic options exist in rare cases of diabetes mellitus, diabetes insipidus, hyperthyroidism, and critical illness-related corticosteroid insufficiency.
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Affiliation(s)
- Andy E Durham
- Liphook Equine Hospital, Liphook, Hampshire GU30 7JG, UK.
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Grahofer A, Wiedemar N, Gurtner C, Drögemüller C, Nathues H. Diagnosis of diabetes insipidus observed in Swiss Duroc boars. BMC Vet Res 2016; 12:22. [PMID: 26832361 PMCID: PMC4734855 DOI: 10.1186/s12917-016-0645-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes insipidus (DI) is a rare disease in humans and animals, which is caused by the lack of production, malfunction or dysfunction of the distal nephron to the antidiuretic effect of the antidiuretic hormone (ADH). Diagnosis requires a thorough medical history, clinical examination and further laboratory confirmation. This case report describes the appearance of DI in five Duroc boars in Switzerland. CASE PRESENTATION Two purebred intact Duroc boars at the age of 8 months and 1.5 years, respectively, with a history of polyuric and polydipsic symptoms had been referred to the Swine Clinic in Berne. Based on the case history, the results of clinical examination and the analysis of blood and urine, a tentative diagnosis of DI was concluded. Finally, the diagnosis was confirmed by findings from a modified water deprivation test, macroscopic examinations and histopathology. Following the diagnosis, three genes known to be involved in inherited DI in humans were analyzed in order to explore a possible genetic background of the affected boars. CONCLUSION The etiology of DI in pigs is supposed to be the same as in humans, although this disease has never been described in pigs before. Thus, although occurring only on rare occasions, DI should be considered as a differential diagnosis in pigs with polyuria and polydipsia. It seems that a modified water deprivation test may be a helpful tool for confirming a diagnosis in pigs. Since hereditary forms of DI have been described in humans, the occurrence of DI in pigs should be considered in breeding programs although we were not able to identify a disease associated mutation.
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Affiliation(s)
- Alexander Grahofer
- Clinic for Swine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Berne, Bremgartenstrasse 109a, CH-3012, Bern, Switzerland.
| | - Natalie Wiedemar
- Institute of Genetics, Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Berne, Bremgartenstrasse 109a, CH-3012, Bern, Switzerland.
| | - Corinne Gurtner
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Länggassstrasse 122, CH-3012, Bern, Switzerland.
| | - Cord Drögemüller
- Institute of Genetics, Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Berne, Bremgartenstrasse 109a, CH-3012, Bern, Switzerland.
| | - Heiko Nathues
- Clinic for Swine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Berne, Bremgartenstrasse 109a, CH-3012, Bern, Switzerland.
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Radin MJ, Yu MJ, Stoedkilde L, Miller RL, Hoffert JD, Frokiaer J, Pisitkun T, Knepper MA. Aquaporin-2 regulation in health and disease. Vet Clin Pathol 2012; 41:455-70. [PMID: 23130944 PMCID: PMC3562700 DOI: 10.1111/j.1939-165x.2012.00488.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aquaporin-2 (AQP2), the vasopressin-regulated water channel of the renal collecting duct, is dysregulated in numerous disorders of water balance in people and animals, including those associated with polyuria (urinary tract obstruction, hypokalemia, inflammation, and lithium toxicity) and with dilutional hyponatremia (syndrome of inappropriate antidiuresis, congestive heart failure, cirrhosis). Normal regulation of AQP2 by vasopressin involves 2 independent regulatory mechanisms: (1) short-term regulation of AQP2 trafficking to and from the apical plasma membrane, and (2) long-term regulation of the total abundance of the AQP2 protein in the cells. Most disorders of water balance are the result of dysregulation of processes that regulate the total abundance of AQP2 in collecting duct cells. In general, the level of AQP2 in a collecting duct cell is determined by a balance between production via translation of AQP2 mRNA and removal via degradation or secretion into the urine in exosomes. AQP2 abundance increases in response to vasopressin chiefly due to increased translation subsequent to increases in AQP2 mRNA. Vasopressin-mediated regulation of AQP2 gene transcription is poorly understood, although several transcription factor-binding elements in the 5' flanking region of the AQP2 gene have been identified, and candidate transcription factors corresponding to these elements have been discovered in proteomics studies. Here, we review progress in this area and discuss elements of vasopressin signaling in the collecting duct that may impinge on regulation of AQP2 in health and in the context of examples of polyuric diseases.
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Affiliation(s)
- M. Judith Radin
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH
| | - Ming-Jiun Yu
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Institute of Biochemistry and Molecular Biology, National Taiwan University College of Medicine, Taipei, TAIWAN
| | - Lene Stoedkilde
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- The Water and Salt Research Center, University of Aarhus, DK-8000 C, Denmark
| | - R. Lance Miller
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jason D. Hoffert
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jorgen Frokiaer
- The Water and Salt Research Center, University of Aarhus, DK-8000 C, Denmark
| | - Trairak Pisitkun
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mark A. Knepper
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Morgan RA, Malalana F, McGowan CM. Nephrogenic diabetes insipidus in a 14-year-old gelding. N Z Vet J 2012; 60:254-7. [DOI: 10.1080/00480169.2012.669723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Moses ME, Johnson PJ, Messer NT, Wilson DA. Antidiuretic response of a horse affected with pituitarypars intermediadysfunction to desmopressin acetate. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2011.00377.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Diabetes insipidus (DI) is a rare disorder of horses characterized by profound polyuria and polydipsia (PU/PD), which can be caused by loss of production of arginine vasopressin (AVP). This condition is termed neurogenic or central DI. DI may also develop with absence or loss of AVP receptors or activity on the basolateral membrane of collecting-duct epithelial cells. This condition is termed nephrogenic DI. Equine clinicians may differentiate true DI from more common causes of PU/PD by a systematic diagnostic approach. DI may not be a correctable disorder, and supportive care of affected horses requires an adequate water source.
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