Renal Lipidosis in Horses and Donkeys: 25 Cases (2008-2022).
Authors: Slavik Kali, Bender Susan, Sharkey Leslie, Nolen-Walston Rose
Journal: Journal of veterinary internal medicine
Summary
# Renal Lipidosis in Horses and Donkeys: Expanding Our Understanding of a Rare Complication Renal lipidosis—abnormal lipid accumulation within kidney tissue—has long been recognised in humans and small animals during serious metabolic disease, yet remains poorly characterised in equids. This retrospective analysis of 25 cases identified between 2008 and 2022 examined the clinical presentation and biochemical profiles of horses and donkeys with concurrent hepatic and renal lipidosis (HL + RL), comparing them against matched cases with hepatic lipidosis alone. Small equids proved significantly more susceptible: donkeys and ponies/miniatures with hepatic lipidosis were 15 and 10 times more likely, respectively, to develop concurrent renal involvement than standard horses, with renal lipidosis never occurring without concurrent hepatic lipidosis. Affected animals predominantly presented with gastrointestinal (64%) or neurologic (48%) signs, and those with dual pathology showed markedly elevated admission plasma lactate (+6.2 mmol/L) and GGT activity (+246 U/L) compared to hepatic-only cases, though traditional kidney markers such as creatinine remained unremarkable. Whilst renal lipidosis appears to be an occasional complication of severe hepatic lipidosis particularly in smaller equine breeds and donkeys, the clinical significance of this finding and its prognostic implications warrant further investigation to guide management decisions in at-risk populations.
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Practical Takeaways
- •Renal lipidosis should be considered a postmortem finding in donkeys, ponies, and miniature horses presenting with concurrent hepatic lipidosis and gastrointestinal or neurologic signs
- •Elevated lactate and GGT at admission may be markers associated with concurrent renal involvement in equids with suspected hepatic lipidosis
- •The clinical significance of renal lipidosis in living equids remains unknown; further research is needed to determine if antemortem diagnosis and intervention are possible or beneficial
Key Findings
- •Renal lipidosis occurred in 0.5% of equid necropsies (25/4680) and was always concurrent with hepatic lipidosis
- •Donkeys and ponies/miniature horses were 15.1 and 9.9 times more likely to have renal lipidosis than horses (p<0.0001)
- •Equids with renal lipidosis had significantly higher admission plasma lactate concentration (+6.2 mmol/L, p=0.04) and GGT activity (+246 U/L, p=0.02) compared to hepatic lipidosis only
- •Gastrointestinal (64%) and neurologic (48%) complaints were the predominant presenting signs in affected animals