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developed in Case 2was easily treated and resolved fairly
quickly after removal of the catheter. It is difficult to ascertain
if the clinical signs such as fever that the filly displayed towards
the end of dialysis were attributable to the peritonitis or to
ongoing enterocolitis. Little exists in the veterinary literature regarding the use of
peritoneal dialysis in large animals. Its successful use has been
reported in cattle for management of azotaemia and uraemia
(Makhdoomi and Marudwar 1992; Singh and Sahu 1995).
There are reports of using peritoneal lavage to reduce
likelihood of post operative peritonitis or adhesions in horses.
In these cases, crystalloid fluids were infused into the
abdomen and afterwards immediately allowed to drain
(Schneider et al.1988; Easter et al.1997; Hague et al.1998).
However, in reviewing the literature, few cases of actual
peritoneal dialysis could be found in horses. One case
involved presurgical management of a foal with a ruptured
bladder (Kritchevsky et al.1984) and the other 2 cases were
horses with ARF due to exertional rhabdomyolysis and
secondary pigment nephropathy (Gallatin et al.2005; Reuss
et al. 2006). Different regimens were used successfully in
those cases, with intermittent peritoneal dialysis being used
in the first case and continuous peritoneal dialysis being used
in the latter 2 cases. It is theorised that peritoneal dialysis
would probably be more effective in horses with nephrotoxic
vs. vasomotor nephropathy and that horses with ARF
secondary to an underlying systemic disease, such as colitis,
are not necessarily the best candidates for peritoneal dialysis,
as they are more likely to be prone to complications and pose
more challenges to the clinician in terms of overall case
management (Schott et al. 2002; Reuss et al.2006).
However, Case 2, which had developed renal failure due to
suspected vasomotor nephropathy responded well to
peritoneal dialysis. In human medicine, it has been shown
that anuric patients have decreased survival in comparison to
those with residual renal function (Szeto et al.2000, 2003;
Wang et al.2005). Although no similar information exists in
veterinary medicine, this suggests that the degree of residual
renal function may be an important factor to take into
account when selecting cases for peritoneal dialysis. To the authors’ knowledge, this is the first report of the
successful use of intermittent peritoneal dialysis for the
treatment of ARF in adult horses. An optimal dialysis regimen
has yet to be determined in the horse; however, the particular
intermittent peritoneal dialysis regimen described here was
used successfully in both clinical cases. This method was
simple to perform, was associated with only minor, treatable
complications, and resulted in good outcomes, suggesting
that peritoneal dialysis may be a valuable tool for the
treatment of ARF in horses.
Manufacturers’ addresses
1Abbott Laboratories, North Chicago, Illinois, USA.2Teleflex, Research Triangle Park, North Carolina, USA.3Ethicon, Somerville, New Jersey, USA.4Johnson & Johnson, Skillman, New Jersey, USA.5Baxter Healthcare, Deerfield, Illinois, USA.6Becton Dickinson, Lincoln Park, New Jersey, USA.
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