A family's beloved pet miniature zebu is recuperating at his home after receiving life-saving hemodialysis treatment for severe kidney injury at the University of Florida Veterinary Hospitals in November.

The 1-year-old animal's nearly fatal kidney injury was likely caused by eating acorns from oak trees on the family's farm in Ocoee, Florida, UF veterinarians said.

The miniature zebu, named Brutus, is believed to be the first bovine patient to have ever received hemodialysis for treatment of acute disease, said Sarah Reuss, V.M.D., a clinical assistant professor of large animal medicine at UF and one of the veterinarians who treated the animal after he arrived at UF on Nov. 18.

The world's smallest breed of cattle, miniature zebus are relatively rare, exotic animals that are frequently kept as pets. Some, such as Brutus, are even trained for the show ring. His proud owners, Mark and Rachel Duncan, plan to show Brutus at the state fair in Tampa in February.

But today, the little guy is lucky to be alive.

"He'd had a two-day history of lethargy, not eating and constipation," said Rob MacKay, BV.Sc., Ph.D., a professor of large animal medicine at UF. "When he arrived at UF, his vital signs were stable, but he was not having the stomach contractions that move food from the stomach into the intestines, and he wasn't producing urine. He also was lethargic and trembling."

Bloodwork and ultrasound revealed that Brutus had acute kidney injury, he said.

"On further discussion with the owners, it was revealed that there were oak trees in Brutus' pasture and that they had seen him eating acorns," MacKay said. "Unfortunately, unbeknownst to his owners, oak leaves and acorns are toxic to cattle, causing both renal and gastrointestinal damage."

Veterinarians began treating Brutus with intravenous fluids and diuretics to try to prompt his kidneys to begin functioning and making urine. He also received rumen transfaunation - basically the transfer of digestive material - from a UF donor steer, which improved Brutus' appetite and stomach motility.

"Fluid balance is very challenging in these patients, as it is easy to give them too much fluid if their kidneys can't excrete it," Reuss said. "He did begin to pass urine, but his indicators of kidney failure continued to increase."

So the large animal medicine team consulted with Carsten Bandt, D.V.M., chief of the college's small animal emergency and critical care service, about the possibility of hemodialysis.

"To the best of our knowledge, this procedure has never previously been performed on a bovine patient outside of a research setting, but Brutus was the perfect candidate based upon his condition of acute toxicity, his size and his very agreeable temperament," Reuss said.

The small animal dialysis team at UF then quickly prepared and inserted a special dialysis catheter into Brutus, who received his first hemodialysis session on Nov. 20.

"He tolerated it like a superstar, quietly standing with hay and lots of scratching," Reuss said.

Overnight, Brutus seemed comfortable and was eating more. After just over a week of treatment at UF, during which time he received two hemodialysis treatments - and became possibly the most doted-on animal ever to be a part-time resident of the UF Small Animal Hospital's intensive care unit - Brutus was discharged Nov. 28 with close to-normal kidney values and every expectation of complete recovery.

Rachel Duncan said their family had fallen in love with miniature zebus while attending a festival in Bushnell with her 16-year-old daughter.

"We looked for local breeders, and along came Brutus," she said, adding that the family also owns another zebu, Jameson, who has become Brutus' buddy and accompanied him to UF on several occasions to keep him company. Jameson also had bloodwork checked to make sure he had also not eaten too many acorns, but fortunately, everything was normal.

Duncan hopes to reach out to the zebu community to raise awareness about acorn toxicity.

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Dr. Rob MacKay, a professor of large animal medicine, and Dr. Carsten Bandt, an assistant professor of emergency and critical care, monitor Brutus, a 1-year-old zebu, during hemodialysis treatment at UF Veterinary Hospitals.
Image credit: The University of Florida College of Veterinary Medicine