Acute kidney Failure

[ladipus]

Last Friday my vet gave my 12yr old Dutch Wb mare the flu/rhino vaccine , sedated for teeth floating and Banamine as she had laminitis a few years prior and we pre treat her ever since. The following evening when I brought her inside she was very dull and lethargic, laid down just a few minutes after being brought in and didn’t want to eat her dinner …she had a low grade fever of 101.3 so vet advised to give another dose of banamine and we chalked it up as a mild vaccine reaction…she perked up a bit and eventually ate her dinner …the next morning (Sunday) she again didn’t want to eat but very slowly finished her breakfast, got turned out for the day and seemed ok but was still very dull …vet advised to give Banamine again that evening …fast forward to Monday morning she was still lethargic /dull and no interest in her meals and had not eaten much hay …also only 1 poop overnight…had vet out (Monday ) she now had a impaction …vet tubed with Magna lax , epsom salt and electrolytes…gave another dose Banamine …she only had 1 more poop that day …vet back out again Tuesday as she’s still the same -lethargic /dull/ no appetite and only pooping 1-2 times in 24 hrs -repeated rectal -still had hard dry poop , tubed again with same stuff and gave dose of Banamine and gave 5 liters IV fluids with dextrose …she remained the same …fast forward now to Wednesday…vet out again …repeated rectal , large amount hard dry poop , tubes again , and took blood for cbc & chemistry…got results that showed elevated creatinine of 4.3 ( high end of normal is 1.8-2) elevated BUN and …potassium also slightly elevated …i then brought her immediately to New Bolten Center -they admitted her to the hospital…took more blood-her creatinine was now 5.9 and blood also detected in urinalysis …they put her on 24 hrs IV fluids …she started to perk back up and pass manure and appetite slowly returned…next day Thursday creatinine down to 4.3…she remained bright & comfortable …Friday creatinine down to 4…I requested ultrasound of the kidneys which showed that they were enlarged-everything else unremarkable…I also requested to test for leptospirosis-still waiting on those results …Saturday down to 3.5…Sunday 3.1, Monday 2.8 and today 2.6 despite being on continuous iv fluids …New Bolten seems to think this is possibly from the banamine even though she was given appropriate amounts (12cc’s once / day for 5 days) beings that banamine is a nephrotoxic drug …my regular vet and myself don’t feel it’s from that and there’s got to be an underlying cause ?? Things that are on my list of possibilities are the vaccine because that’s the only thing that she had and was fine prior to it …other things I’ve been racking my brain with of what could it be from the supplements she takes for her Pssm2 and MFM?? She’s been on KER MFM pellets since last November when she got diagnosed-that supplement is an ultra concentrated Amino Acid /Protein supplement ??

I asked NBC if it’s concerning that her levels still aren’t back to normal after 6 days on IV fluids …they said they don’t love that it’s taking this long but sometimes it does …they aren’t overly concerned and seem optimistic that she will be ok…however everything I’ve read on this says generally you will see a 30-50% decrease in creatinine level after 24hrs on iv fluids ….my regular vet on the other hand is quite doom and gloom about this saying she could potentially need to be euthanized if her levels go back up once off fluids …and also about her long term prognosis in the future saying it’s unlikely to think that she won’t ever need bute or banamine the rest of her life …what if she colics , gets injured etc etc then what do you do ? He put the fear of god in my telling me that her kidneys are damaged and you can’t reverse it …and they will onlY worsen over time.

Anyhow …has anyone ever dealt with something like this ?? Please tell me there’s hope of her to return to normalcy

[Junebuggie]

I haven’t experienced anything of this nature, but I am so sorry you are having to go through this. Hugs and jingles.

[ladipus]

Thank you

[trubandloki]

Jingles!

Wow.

I have no input on the actual situations, just adding support.

[theresak]

She wasn’t on Equioxx or any topical NSAID before the vaccines and banamine, correct? Have you tested for Cushings?

[starsandsun]

Assuming your vet can call vaccine manufacturer and ask if others have reported this kind of response after vaccine? I’d look more at vaccine than banamine.

[ladipus]

Correct …she was not on any nsaid prior to vaccines/dental floating …she only received Banamine & dormosedan (Zoetis) and Fluvac Innovator 4/1( Zoetis) last Friday …and no she did not have Cushings when tested last fall at New Bolten Center with a complete metabolic panel.

[ladipus]

Yes …yesterday I had my vet contact Zoetis and report this as a possible vaccine reaction…they should be contacting myself as well as New Bolten Center for follow up.

[ladipus]

Thank you

[ladipus]

Just heard from nbc …they said her creatinine level has remained the same at 2.6 …so their plan is to stop iv fluids today …and recheck creatinine tomorrow and Thursday and as long as it’s not shooting back up then they think she should be ok to come home Friday and recommend weekly creatinine checks by the home vet…I might opt to keep her there throughout the weekend for close monitoring because I will not be home much both Saturday & Sunday …fingers crossed

[ATXmom]

I don’t have any experience with this specific root issue but several years ago, my daughter’s horse choked overnight (wasn’t discovered until many hours later) and ended up in the emergency clinic. His creatinine levels were about the same as your mare and our vet was similarly doom and gloom. His levels never came down despite being flooded with fluids, but hopefully, since your mare is responding, she will have a better outcome.

jingling for you and your girl!

[ATXmom]

Just remembered seeing this banamine recall

https://www.chronofhorse.com/article/merck-recalls-three-batches-of-banamine/

[ladipus]

Fortunately she received the generic brand not Merck

[ATXmom]

Glad to hear!

[cayuse]

Jingles for your mare!

[Living_In_The_Sticks]

Not with kidneys but had this come up up my old guy & his liver. You can’t reverse kidney disease/damage but you can maintain what is left.

I get where your vet is freaking out about numbers because I did that too. His numbers went up while he was there Numbers are just numbers & you have to look at the patient in front of you. She sounds better & numbers are going down. NBC isn’t worried so just see what happens. I’d leave her there though the weekend if you won’t be around much.

I’m leaning towards the vaccine & don’t think it was the banamine. It’s not great to have it 5 days in a row but you have to do what you have to do. They’ll send you home with instructions for diet, etc. It will have to be low protein & alfalfa is probably off the menu for good. The first few days back home were rough because you keep waiting for the other shoe to drop. I hope she keeps improving for you!

[Skip_s_Rider]

My horse went into kidney failure after being treated with oxytet and IV bute for anaplasmosis. We administered IV fluids twice daily for three days and then oral fluids on the fourth day. I don’t remember offhand what his blood values were on the fourth day. They had gone down but were not back to normal. The vet recommended we turn him out with ample grass to increase his fluid intake. We have automatic waterers in our barn, but I always hang an extra bucket that gets cleaned every day. He prefers drinking out of the bucket. The vet also recommended avoiding any medications that might be hard on the kidneys (bute, banamine, oxytet). His next dose of bute was 7 months later when he got vaccines, and he only gets it sparingly now.

At a conference, my vet talked with several other vets who had horses that went into kidney failure after receiving oxytet. She believes my horse was probably a bit dehydrated when he got the oxytet and IV bute, which made his kidneys more susceptible to failure.

This happened 14 months ago, and he seems fine now. So, yes, there’s hope. I was lucky that the vet rechecked my horse ~14 hours after the initial oxytet and bute treatment. He showed no improvement, and my vet immediately ran bloodwork.

Best of luck with your horse. Hang in there. I know how hard this is.

[ladipus]

Thank you …That’s very encouraging to hear …I’ve been praying for a positive outcome and I’m anxiously awaiting for my update today and praying that her levels didn’t go back up since stopping fluids yesterday.

[ladipus]

I heard from new Bolten yesterday late afternoon- her creatinine increased a little bit from 2.6 to 2.9 and her urinalysis still shows some stuff going on…urine not concentrating as well as it should be just yet and still showing some red blood cells(this is about 48 hours after stopping IV fluids) …they said she’s still bright, alert , happy and doing very well clinically -they said she’s ready for discharge but I asked if she could stay throughout the weekend since I won’t be home much to closely monitor …they said that’s a great idea and will re check the creatinine & urinalysis Monday before she comes home! New Bolten still does not seem overly concerned.

[ladipus]

Great news ! Schimpie’s creatinine is down to 2.4 from 2.9 Thursday -lowest it’s been yet and has been off iv fluids since Tuesday!! She gets to come home today !