Accuracy of differences in blood and peritoneal glucose to differentiate between septic and non-septic peritonitis in horses.
Abstract: Difference in blood and peritoneal glucose (DBPG) is used in clinical practice to support a diagnosis of septic peritonitis in horses. It is inexpensive, easy and rapid to perform. The aim of this study was to evaluate the accuracy of the DBPG to differentiate between septic and non-septic peritonitis in horses. Blood and peritoneal fluids were harvested from suspected animals. Plasma and peritoneal glucose levels, total nucleated cell count, direct microscopic and microbiological examinations of the peritoneal fluid were evaluated. Using DBPG levels, the animals were classified into two groups: difference ≥ 50 mg/dL (positive test) and difference < 50 mg/dL (negative test). Positive microbiological examination and/or presence of bacteria in direct microscopic examination was used as a gold standard to detect septic peritonitis. The accuracy parameters analysed were: sensitivity, specificity, and positive/negative predictive values, for which the results were respectively: 0.23, 0.91, 0.60 and 0.67. Due to poor accuracy, other cut-off margins and peritoneal glucose concentrations were evaluated. The test was considered most accurate when the DBPG was zero with sensitivity, specificity, and positive/negative predictive values of 0.85, 0.82, 0.73, 0.90 respectively. Peritoneal glucose concentrations alone were not a reliable feature to detect peritonitis. DBPG ≥50 mg/dL, widely used for the diagnosis of septic peritonitis, does not have a good accuracy and the DBPG = 0 has a better accuracy for detecting the disease.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Publication Date: 2020-06-20 PubMed ID: 32634704DOI: 10.1016/j.rvsc.2020.06.017Google Scholar: Lookup
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- Journal Article
Summary
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This research aims to evaluate the accuracy of using the Difference in Blood and Peritoneal Glucose (DBPG) in diagnosing septic peritonitis in horses; it reveals that DBPG did not have a good accuracy for detecting the condition, and requires further investigation.
Objective and Methodology
- The study’s primary goal was to verify the accuracy of differences in blood and peritoneal glucose (DBPG) in differentiating between septic and non-septic peritonitis in horses.
- Blood and peritoneal fluids were sampled from a group of suspected animals to perform this analysis.
- The research measured the plasma and peritoneal glucose levels of these specimens, the total nucleated cell count, direct microscopic observations, and microbiological examinations of peritoneal fluid.
Test and Parameters
- Horses were classified into two groups based on their DBPG levels: those with a difference above or equal to 50 mg/dL (positive test) and those with a difference below 50 mg/dL (negative test).
- The gold standard for identifying septic peritonitis in this study was positive microbiological testing or the presence of bacteria in direct microscopic examination.
- Accuracy parameters consist of sensitivity, specificity, and positive/negative predictive values.
Findings
- The results showed sensitivity of 0.23, specificity of 0.91, positive predictive value of 0.60, and negative predictive value of 0.67 for DBPG ≥50 mg/dL, which is widely used in clinical practice.
- Due to the poor accuracy demonstrated in the initial tests, other cut-off margins and peritoneal glucose concentrations were evaluated.
- It was found that the test was most accurate when the DBPG was zero with sensitivity, specificity, and positive/negative predictive values of 0.85, 0.82, 0.73, 0.90 respectively.
- Peritoneal glucose concentrations alone were found insufficient as a reliable method to detect peritonitis.
Conclusion
- The study concluded that differences in blood and peritoneal glucose (DBPG ≥50 mg/dL), broadly employed to diagnose septic peritonitis, were not an accurate measure.
- The research found better accuracy when the DBPG value was zero, indicating that DBPG needs to be reassessed as a diagnostic tool in clinical practice.
Cite This Article
APA
Alonso JM, Esper CS, Pantoja JCF, Rosa GDS, Giampietro RR, Dos Santos B, Guerra ST, Ribeiro MG, Takahira RK, Watanabe MJ, Alves ALG, Rodrigues CA, García HDM, Hussni CA.
(2020).
Accuracy of differences in blood and peritoneal glucose to differentiate between septic and non-septic peritonitis in horses.
Res Vet Sci, 132, 237-242.
https://doi.org/10.1016/j.rvsc.2020.06.017 Publication
Researcher Affiliations
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil. Electronic address: juliana.alonso@unesp.br.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Internal Medicine, Botucatu Medical School, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Botucatu, Univ. Estadual Paulista (Unesp), Brazil.
MeSH Terms
- Animals
- Ascitic Fluid / chemistry
- Bacterial Infections / diagnosis
- Bacterial Infections / veterinary
- Blood Glucose
- Female
- Glucose / chemistry
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horses
- Male
- Peritonitis / blood
- Peritonitis / diagnosis
- Peritonitis / veterinary
Conflict of Interest Statement
Declaration of Competing Interest The authors state no conflict of interests.
Citations
This article has been cited 3 times.- Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
- Bishop RC, Arrington JV, Wilkins PA, McCoy AM. Alterations in the Peritoneal Fluid Proteome of Horses with Colic Attributed to Ischemic and Non-Ischemic Intestinal Disease. Animals (Basel) 2025 May 30;15(11).
- Birckhead EM, Das S, Tidd N, Raidal SL, Raidal SR. Visualizing neutrophil extracellular traps in septic equine synovial and peritoneal fluid samples using immunofluorescence microscopy. J Vet Diagn Invest 2023 Nov;35(6):751-760.
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