Renal Failure, Acute
Basic Information 
Clinical Presentation
History, Chief Complaint
• Treatment with nephrotoxic drugs
• Hemolysis, rhabdomyolysis (pigmentary nephropathy)
• Oliguria (but urine production may be normal to polyuric)
• Urinary tract obstruction or disruption (urolithiasis, ruptured bladder)
• The predominant clinical signs are usually attributable to another primary problem that caused dehydration.
Etiology and Pathophysiology
• Dehydration: Administration of nephrotoxic drugs.
• Dehydrated animals depend on renal production of prostaglandins to maintain renal perfusion. Because most NSAIDs used in horses are nonselective cyclooxygenase inhibitors, their use in dehydrated animals blocks the kidneys’ ability to increase its blood flow.
• Pigmentary nephropathy results when myoglobin or hemoglobin polymerizes and occludes renal tubules.
• Aminoglycosides are freely filtered at the glomerulus and are actively taken up by proximal tubular epithelial cells. Toxicity may involve lysosomal disruption and leakage of proteolytic enzymes.
• Postrenal azotemia occurs with occlusion of urinary outflow, backpressure in the collecting system, and resultant decreased renal blood flow.
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