Chronic kidney disease in adult horses: causes, diagnosis and management

Chronic kidney disease is a rare disease in horses, unlike humans and companion animals where it is frequently encountered. There are multiple causes, although, since the disease typically presents late in the disease process, the instigating factor is often not ascertained. Clinical signs most commonly include weight loss, ventral oedema and polyuria-polydipsia. There is a need for more sensitive markers of renal damage or dysfunction so that the disease can be detected earlier in its course. Serum symmetric dimethylarginine and neutrophil gelatinase-associated lipocalin are potential biomarkers that are being investigated in this regard. Currently, once the diagnosis has been made, treatment is supportive only, with no options to halt the progression of the disease. Although this is a terminal condition, horses can be maintained with an adequate quality of life for several years after diagnosis in some cases.