Risk factors associated with renal insufficiency in horses with primary gastrointestinal disease: 26 cases (2000-2003)

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 groups 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 AIR 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 AIR 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.