Short-term mortality prediction based on biochemical blood markers in azotemic cattle with renal disease.

Combined plasma creatinine and SDMA assessment can predict short-term survival with 87.5% accuracy in azotemic cattle.

This prospective cohort study evaluated blood and urine biomarkers as short-term prognostic indicators in 34 azotemic adult cattle with suspected renal disease, referred to the National Veterinary School of Toulouse. Renal disease was confirmed via urinalysis or ultrasonography, with post-mortem gross and histologic examination performed in fatal cases. Of the 34 cattle, 13 were discharged (favorable outcome) and 21 died or were euthanized (unfavorable outcome). Statistical analyses including correlation, univariate and multivariate testing, ROC curve analysis, and decision tree modeling were employed to identify predictive biomarkers. Mortality was significantly associated with elevated plasma symmetric dimethylarginine (SDMA), creatinine, and urea concentrations, as well as hypocalcemia, hypochloremia, and reduced hematocrit. Among all evaluated markers, creatinine, SDMA, chloride, and albumin demonstrated the most consistent predictive value for outcome. A decision tree model combining plasma creatinine and SDMA achieved 87.5% diagnostic accuracy. Cattle with plasma creatinine below 605 μmol/L combined with SDMA below 33 μg/dL had the highest probability of survival. These findings suggest that routinely available biochemical parameters—particularly creatinine, SDMA, urea, chloride, and albumin—can serve as clinically useful prognostic tools in azotemic cattle. The combined SDMA and creatinine decision tree offers a practical framework to support clinical decision-making regarding triage, treatment intensity, and humane euthanasia considerations in cattle with renal disease.

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