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  Discussion on Use of diuretic in horse with chronic diarrhea
Author Message
New Member:
carolann

Posted on Friday, Jul 18, 2008 - 11:55 am:

My 11 year old gelding has had chronic diarrhea for awhile now. He drinks large amounts of water but it doesn't come out as urine but as watery diarrhea. My new vet has put him on a course of diuretics and wants to see improvement in a week. I am confused about the course. I've noticed that when the water is regulated- 1/2 bucket every couple of hours, the stool and urine return to "normal". It's only when he is given free water does the watery diarrhea take place. What are your thoughts? Thank you.
Member:
scooter

Posted on Friday, Jul 18, 2008 - 11:28 pm:

Hi Carol, Out of curiosity is your horse stalled? I know I ran across a few horse that were stalled and out of boredom would lick their salt block and then drink way more water than normal. Have seen dry lotted horses do it too. An over abundance of salt can give them diarrhea also. We started limiting the salt and that pretty much cleared it up.
New Member:
carolann

Posted on Monday, Jul 21, 2008 - 12:52 pm:

He is stalled but not with a salt block. His blood tests came back negative as well.
Member:
scooter

Posted on Tuesday, Jul 22, 2008 - 7:50 am:

I am curious why your horse was given diruetics?

Some horses do drink more when stalled, especially when on a "feeding schedule" basically out of boredom, is it possible to give him free choice grass hay when he is stalled?
Moderator:
DrO

Posted on Tuesday, Jul 22, 2008 - 8:31 am:

Hello carol,
How much water is your horse drinking a day and has anyone checked the urine's specific gravity during the controlled water times? There are some medical conditions that would give you the problems you see though I can think of. For more on this see » Diseases of Horses » Urinary System » Excessive Drinking and Urination, Polydipsia / Polyuria (PD/PU).
DrO
New Member:
carolann

Posted on Tuesday, Jul 22, 2008 - 5:55 pm:

He is given free choice grass hay. He will drink 2 full buckets in the morning if allowed- sucks them down fast! He has gone through 5 or 6 buckets a day. He is also very hungry all of the time. The diruetics are being tried as a diagnostic tool to see if they would flush the intestines and allow the water to filtrate through the kidneys. He only urinates 2 times a day as of now. Neither I or my vet had heard of this type of situation- meaning, the more he drinks, the more watery the diarrhea becomes. He usually has a bout right after eating, then more solid during the day (with water somewhat restricted) then another bout after pm feeding. I have read about the Polydipsia but this horse is not urinating. When we regulate the water he seems to loose interest in wanting water after awhile even when it is hot out. The curious thing is he is more solid at a horse show but again the water is limited and the hay is always infront of him. Again, overall he is healthy- a little underweight, a joy to ride- doesn't act like he is in any discomfort so it doesn't seem like ulcers. He was treated briefly for ulcers before we bought him but it did not solve the problem.
Dr. O- We have not had a urine test just blood and his stool did have some sand in it which he has been on Sand Clear for weeks now. What if the diruetic does move the liquid to the kidney? What does that mean and what if it doesn't?
Thanks.
Member:
rtrotter

Posted on Tuesday, Jul 22, 2008 - 6:19 pm:

Carol,

The one thing I see in your post is that our horse has been on Sand Clear for weeks. Sand Clear should be used for 1 week a month. Sand Clear absorbs the water in a horse's digestive system and as it pushes the digested material out as manure it is supposed to pick up the sand along the way. Drinking a lot of water may be your horse's way of clearing the unneeded Sand Clear out of his system.

It may be the Sand Clear that is causing your problem. Did you test your horse to see how much sand/dirt was in his manure?
Moderator:
DrO

Posted on Wednesday, Jul 23, 2008 - 7:19 am:

I don't think anything can be deduced if the diuretic decreases fecal water, it almost certainly will, but to what extent I do not know. If this is being done as a diagnostic test I would love to know the reasoning.

The article I reference above discusses the importance of checking urinary function in cases of excessive drinking and useful tests you can do to see if it would be safe to limit water consumption to your horse: in short if your horse can concentrate urine yes it should be safe but this needs to be checked. We have seen a horse that had normal kidney function and what appeared to be a water consumption associated diarrhea.
DrO
New Member:
carolann

Posted on Wednesday, Jul 23, 2008 - 9:19 am:

The horse drank a lot of water before sand clear and still had some sand after the use of sand clear. As for the urine test, what would we be looking for to tell us if it would be safe to limit water consumption? If limiting helps is it safe to say that this is a water consumption diarrhea issue? I did ask the vet what the purpose was to give the diuretic as I had never heard of this. I gathered that it would tell him if he could get the water to move through the kidney because he mentioned if it couldn't then he would look into a possible colonoscopy. I am unsure what path to take- should I request a urine test, stool test?
Carol
Member:
carolann

Posted on Wednesday, Jul 23, 2008 - 2:37 pm:

One more question as I have researched polydipsia- how do we know if the diarrhea is causing a temporary polydipsia condition?
Carol
Moderator:
DrO

Posted on Thursday, Jul 24, 2008 - 8:42 am:

By following the diagnostic recommendations in the article you can determine first are the kidneys able to concentrate urine and if not why. Whether the diarrhea is the cause or an effect of the excessive water consumption is a interesting question that only gets answered by ruling in some other disease or ruling out problems of the bowel. The observation that it stops when water is controlled suggest to me it is an effect. For more on the diagnosis of diarrhea see Diseases of Horses » Colic, Diarrhea, GI Tract » Diarrhea in Horses » Diarrhea an Overview.
DrO
Member:
carolann

Posted on Thursday, Jul 24, 2008 - 10:51 am:

Thank you Dr. O. I think an urinalysis is in order then. Do you recommend a stool sample as well? We had him on Sand Clear and took him off and the diarrhea became watery again.
Carol
Moderator:
DrO

Posted on Friday, Jul 25, 2008 - 9:32 am:

Not just a stool sample carol but I would consider all the diagnostic steps in the diarrhea overview article.
DrO
Member:
carolann

Posted on Tuesday, Aug 12, 2008 - 5:11 pm:

Dr. O,
We did blood, urine, and stool samples and here is what we got. The blood sample had 2 curious results- the total bilirubin was 4.2 (high)and the direct bilirubin was high at 0.7. The BUN and Creatinine were within normal range. For the urine we collected after a diuretic was administered so I am unsure if the results were valid but it showed the specific gravity was low at 1.006. The stool sample was negative on both sand and parasites. The vet said the blood and urine results were fine and did not know what to do next. I finally spoke to the previous owner who said the horse was on generic ulcer medicine and had been solid for them. ???? What should my next step be? The blood work-up makes me concerned for his liver but the vet did not seem concerned. We have taken him off of Sand Clear but the watery diarrhea returned.
Carol
Moderator:
DrO

Posted on Tuesday, Aug 12, 2008 - 6:35 pm:

You are correct, the diuretic nullifies the specific gravity as a useful test. We are trying to find out if there is a problem with the urinary system ability to concentrate urine causing the over ingestion of water. It should be repeated a week after discontinuing any diuretic. I agree the bilirubin numbers don't appear significant with any current clinical signs.
DrO
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