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Putative uremic encephalopathy in horses: five cases (1978–1998)

Melinda A. FryeDepartment of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523- 1620.

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Jeremy S. JohnsonDepartment of Pathology, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523- 1620.

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Josie L. Traub-DargatzDepartment of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523- 1620.

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 DVM, MS, DACVIM
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Catherine J. SavageArrabri Equine Internal Medicine LLC, 35389 Millville Rd, Middleburg, VA 20118.

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Martin J. FettmanDepartment of Pathology, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523- 1620.

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Daniel H. GouldDepartment of Pathology, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523- 1620.

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Abstract

Objective—To determine historical, physical examination, clinicopathologic, and postmortem findings in horses with putative uremic encephalopathy.

Design—Retrospective study.

Animals—5 horses with renal failure and neurologic disease not attributable to abnormalities in any other organ system.

Procedure—Medical records from 1978 to 1998 were examined for horses with renal disease and neurologic signs not attributable to primary neurologic, hepatic, or other diseases. Signalment, history, physical examination findings, clinicopathologic data, renal ultrasonographic findings, and postmortem data were reviewed.

Results—Of 332 horses with renal disease, 5 met selection criteria. Historical findings, physical examination findings, clinicopathologic data, ultrasonographic data, and postmortem findings were consistent with chronic renal failure. Swollen astrocytes were detected in all 4 horses examined at necropsy.

Conclusions and Clinical Relevance—A single criterion was not determined to be pathognomonic for uremic encephalopathy in horses. Uremic encephalopathy should be considered as a differential diagnosis in horses with evidence of chronic renal failure and encephalopathic neurologic sign not attributable to other causes. Astrocyte swelling, which was common to all 4 horses examined at necropsy, may serve as a microscopic indicator of uremic encephalopathy in horses. (J Am Vet Med Assoc 2001;218:560–566)

Abstract

Objective—To determine historical, physical examination, clinicopathologic, and postmortem findings in horses with putative uremic encephalopathy.

Design—Retrospective study.

Animals—5 horses with renal failure and neurologic disease not attributable to abnormalities in any other organ system.

Procedure—Medical records from 1978 to 1998 were examined for horses with renal disease and neurologic signs not attributable to primary neurologic, hepatic, or other diseases. Signalment, history, physical examination findings, clinicopathologic data, renal ultrasonographic findings, and postmortem data were reviewed.

Results—Of 332 horses with renal disease, 5 met selection criteria. Historical findings, physical examination findings, clinicopathologic data, ultrasonographic data, and postmortem findings were consistent with chronic renal failure. Swollen astrocytes were detected in all 4 horses examined at necropsy.

Conclusions and Clinical Relevance—A single criterion was not determined to be pathognomonic for uremic encephalopathy in horses. Uremic encephalopathy should be considered as a differential diagnosis in horses with evidence of chronic renal failure and encephalopathic neurologic sign not attributable to other causes. Astrocyte swelling, which was common to all 4 horses examined at necropsy, may serve as a microscopic indicator of uremic encephalopathy in horses. (J Am Vet Med Assoc 2001;218:560–566)