Acute Renal Failure: Peritoneal Dialysis Provides New Hope for Horses

Acute renal failure used to be a death sentence for a horse, but a new procedure pioneered by Laurie Gallatin, DVM, Dipl. ACVIM, of Purdue University School of Veterinary Medicine, and successfully used by Sarah Reuss, VMD, a veterinary resident instructor at Texas A&M University, could be a viable option for getting horses with this condition through the most dangerous period. Reuss presented her experiences with the method at the 2006 AAEP Convention.

Reuss has used continuous peritoneal dialysis to allow the toxins that the kidneys usually filter to diffuse across the peritoneum (lining of the abdominal cavity), into the dialysate (material that passes through the membrane in dialysis), then out into a collection bag.

This method relies on the permeability of the peritoneum to filter toxins and gives horses a fighting chance in cases where they are unable to produce urine.

Reuss' method uses a fluid drip from an ingress portal (the opening where fluid flows in) in the left flank area to an egress portal (place for excess fluid to escape) along the middle of the belly.

The fluid washes across the peritoneum and toxins diffuse into the fluid that is collected via gravity in a urine collection bag under the horse. Reuss uses 1.5% dextrose in a balanced polyionic solution. While solutions containing up to 5% dextrose have been used in human dialysis, Reuss said this might be irritating to the horse's peritoneum.

According to Reuss, this method can be used continuously for several days with the horse loose in a stall. Both portals should be checked for leakage, and the egress portal should be checked for obstruction. So long as sterility can be maintained, Reuss said to leave the system in place until the horse is producing urine and the azotemia (excess of creatinine and urea) is resolved.

Overall, Reuss calls this method a "viable treatment option for horses in acute renal failure," and she encouraged veterinarians in referral and university hospitals to initiate it early to significantly reduce the morbidity and mortality associated with the condition.



Get research and health news from the American Association of Equine Practitioners 2006 Convention in The Horse's AAEP 2006 Wrap-Up sponsored by OCD Equine. Files are available as free PDF downloads.

About the Author

Erin Ryder

Erin Ryder is a former news editor of The Horse: Your Guide To Equine Health Care. She owns a portly gray gelding named Duncan and dabbles in several equestrian disciplines, with an emphasis on dressage.

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