Managing Renal Failure in a Pregnant Mare

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Cleo’s Journey Through Renal Failure-
Back in January, my 17 year old pregnant mare went off feed and just wasn’t acting like herself. Nothing dramatic, just enough that I knew something wasn’t right. We hauled her to the vet, pulled bloodwork and a urinalysis, and started supportive care while waiting for results.
Three days later, everything changed........
The tests showed a urinary tract infection, but more concerning than that, Cleo was in renal failure. The theory is that the infection ascended into her bladder and eventually reached her kidneys.
Once we got the diagnosis, Banamine was immediately discontinued and she was started on SMZ antibiotics. She was admitted to Central Washington Equine Hospital for IV fluids in hopes of supporting her kidneys.
After 24 hours of fluids, repeat bloodwork showed something both encouraging and terrifying. The tubular portion of her kidneys appeared to still be functioning, but the glomerular portion was not functioning normally. From there, she was referred to Washington State University Veterinary Teaching Hospital for additional diagnostics.

WSU admitted they had never seen a case quite like this before. There were specialists, students, and multiple departments involved, all trying to figure out how to support both Cleo and the little bun in the oven.

One of the hardest parts of this entire journey was the uncertainty. There is very little information out there about pregnant mares surviving renal failure. Every veterinarian we spoke with was compassionate and helpful, but even the specialists admitted they had very limited experience with a case like this.

People gently prepared me for the possibility that neither Cleo nor the foal would make it.  But if you know me, you know I was going to fight for her.

One thing that surprised me the most was how difficult it was to figure out what to feed her. A pregnant mare in renal failure is a very specific balancing act nutritionally. You are trying to support compromised kidneys while also growing a healthy foal.

​Feeling like we needed more guidance, I reached out to Kentucky Equine Research ker.com/ and asked if they would review Cleo’s case.

THEY WERE INCREDIBLE!!!

I sent them hay analysis reports, bloodwork, veterinary records, and feeding information. From there, they helped formulate a feeding plan specifically tailored to Cleo’s condition and pregnancy. I truly believe their nutritional guidance played a huge role in getting her successfully to full term.

The last several months have honestly been exhausting in every possible way. Horse people get very good at functioning through stress. We still feed, medicate, clean stalls, haul to appointments, and keep moving while quietly falling apart behind the scenes.
I genuinely think I cried more in the last few months than I have in the previous five years combined.

But through all of it, Cleo was such a steady soul. Even on her worst days, when she was urinating blood, she still greeted me, took her meds like a champ & still fought.

As her due date approached, WSU agreed to foal her out so she could be closely monitored during delivery. We hauled her there on April 27th. I’m fairly certain the staff was a little overwhelmed by my detailed feeding instructions and carefully organized routine, but they were absolutely wonderful about following the plan and keeping me updated daily.

Then on Thursday, June 14th at 5:05 PM, I got the call I had been hoping and praying for.
Cleo was in labor.  After months of fear and preparing ourselves for every possible complication, the delivery was completely textbook and baby Josie safely made her way into the world.

She is tiny, feisty, and absolutely perfect.

Watching videos of her standing, nursing, and being her spicy little self felt surreal after everything it took to get here.

Even now, we are still navigating the realities of Cleo’s kidney disease. Her milk currently contains extremely elevated creatinine levels, which became another concern immediately after foaling. Thankfully, Josie’s bloodwork has shown that her kidneys are currently able to process and flush it appropriately.

For now, she continues to nurse while we monitor both of them very closely.
Kentucky Equine Research is currently reviewing the newest lab work and helping formulate an updated nutritional plan to support both Cleo and Josie through lactation.
The reality of owning and breeding horses is not always polished highlight reels and happy endings. Sometimes it is beautiful. Sometimes it is devastating. Most of the time, it is both.

I’m sharing this because I know there may be another horse owner somewhere desperately searching the internet after hearing the words “renal failure” from their veterinarian, looking for even one story that offers some hope.

If that is you, ask questions. ADVOCATE for your horse. Build a veterinary team you trust. Take things one day at a time, & reach out to me!  I would love to hear your story & be a sounding board for you.

-Dana

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