Acute phase proteins as diagnostic markers in horses with colic

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Tina Pihl, Elrien Scheepers, Macarena Sanz, Amelia Goddard, Patrick Page, Nils Toft, Mads Kjelgaard-Hansen, Pia Haubro Andersen, Stine Jacobsen

Objective - To investigate the diagnostic potential of acute phase proteins (serum amyloid A (SAA), haptoglobin and fibrinogen) measured in blood and peritoneal fluid for differentiating horses with inflammatory colic (entero-colitis and peritonitis) from those with surgical colic. Design - Prospective observational multicenter study. Setting - Two university referral hospitals. Animals - Horses referred for severe acute abdominal pain to hospital 1 (n=148) or hospital 2 (n=78). Intervention - Blood and peritoneal fluid samples collected at admission were used for acute phase protein measurement. Measurements and Main Results - A multivariable logistic model including clinical parameters (lethargy, rectal temperature > 38◦C, normal rectal findings and gastric reflux of 5-10 L) recorded at admission was constructed from hospital 1 data. The ability of the model to correctly differentiate inflammatory from surgical colic was 86% determined as area under the receiver operating characteristic curve (AUC). Adding blood parameters (white blood cell count (WBC), packed cell volume (PCV), total plasma protein, lactate, SAA, haptoglobin and fibrinogen) to the logistic model based on clinical parameters revealed that only SAA, WBC and fibrinogen improved the model. With SAA included in the model no additional blood parameters improved the model, and the final model had an AUC of 90%. Addition of peritoneal fluid parameters (hemolysis, total protein, WBC, SAA, haptoglobin) did not improve the model significantly. When validated in hospital 2 data, the models had a satisfying integrity and diagnostic performance. Conclusions – Evaluation of SAA in serum improved the ability to differentiate horses with acute inflammatory colic requiring medical treatment from horses with colic requiring surgical treatment, as it allowed an additional 4% of horses to be correctly classified into medical and surgical cases. Improved differentiation of these two groups of horses with colic may minimize the risk of unnecessary or delayed surgery.
OriginalsprogEngelsk
TidsskriftJournal of Veterinary Emergency and Critical Care
Vol/bind26
Udgave nummer5
Sider (fra-til)664–674
Antal sider11
ISSN1479-3261
DOI
StatusUdgivet - 2016

    Forskningsområder

  • Det Sundhedsvidenskabelige Fakultet - Acute phase proteins, surgery, diagnostic accuracy, horse, colic, white blood cell count, lactate, peritoneal fluid, fibrinogen, haptoglobin, serum amyloid A

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