Association between hyperglycemia and survival in 228 horses with acute gastrointestinal disease.
Abstract: Glucose homeostasis is dysregulated in critically ill humans resulting in hyperglycemia and decreased survival. Hyperglycemia is common in horses presenting with abdominal crisis, and this might be associated with a worse prognosis for survival. Objective: To determine if hyperglycemia in horses with acute abdominal disease is associated with increased odds of failure to survive to hospital discharge. Methods: Two hundred and twenty-eight adult horses with acute gastrointestinal disease. Methods: Observational retrospective study. Records of horses > 1 year of age presenting for treatment of colic over a 3-year period were reviewed. Data collected included age, duration of colic, glucose, heart rate, PCV, total protein, anion gap, cost of hospitalization, breed, sex, pain at admission, diagnosis, whether surgery was performed, and life status at hospital discharge. Potential risk factors for nonsurvival were screened by univariable logistic regression and the best-fitting univariable model was used as the basis for multivariable regression modeling. Results: Mean blood glucose was 155 mg/dL (8.5 mM) with 45% of the population above the reference range; 16.7% (38 of 228) of horses had severe hyperglycemia (>195 mg/dL; 10.7 mM). Factors associated with increased odds of failure to survive included glucose, severity of pain at admission, heart rate, PCV, anion gap, and diagnosis. The best-fitting multivariable model included glucose and diagnosis, with age included as a confounding variable. The model correctly classified outcome for 92.5% of horses. Conclusions: This study has confirmed prior reports that hyperglycemia is common in horses with colic and is associated with a worse prognosis for survival to hospital discharge.
Publication Date: 2009-09-22 PubMed ID: 19780927DOI: 10.1111/j.1939-1676.2009.0395.xGoogle Scholar: Lookup
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- Journal Article
Summary
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This research study investigates the link between high blood sugar levels (hyperglycemia) and survival rates in horses dealing with acute gastrointestinal disease. The study suggests that, similar to human patients, horses presenting with an abdominal crisis alongside high blood sugar levels may have a worse prognosis and lower survival rate.
Overview of the Study
The researchers carried out a retrospective observational study. Over a three-year period, the team reviewed records of 228 horses aged one year or older that were treated for colic, a common gastrointestinal condition in horses.
- The data collected encompassed several variables such as the horse’s age, breed, sex, the length of the colic episode, their heart rate and glucose levels, the packed cell volume (PCV) and total protein, the anion gap, the cost of hospitalization, whether surgery was performed, the diagnosis, and their pain levels when admitted.
Statistical Analysis
A univariable logistic regression was used to screen potential risk factors for non-survival. The results were then used as a basis for creating a multivariable regression model to determine the associations between hyperglycemia and survival rates.
- Mean blood glucose of the horses was found to be 155 mg/dL, with nearly half of the horse population above the reference range.
- Approximately 16.7% of the horses presented severe hyperglycemia, with glucose levels exceeding 195 mg/dL.
- The identified factors associated with increased odds of failure to survive included glucose levels, the severity of the pain at admission, heart rate, PCV, the anion gap, and the diagnosis.
Results of the Study
The research team was able to successfully develop a model that correctly classified the outcome for 92.5% of the horses.
- Hyperglycemia was confirmed to be common among horses diagnosed with colic.
- The study demonstrated a distinct correlation between elevated glucose levels and lower survival rates upon hospital discharge after treatment.
- The researchers concluded that hyperglycemia in horses experiencing acute abdominal disease might signify a worse prognosis for survival.
Cite This Article
APA
Hassel DM, Hill AE, Rorabeck RA.
(2009).
Association between hyperglycemia and survival in 228 horses with acute gastrointestinal disease.
J Vet Intern Med, 23(6), 1261-1265.
https://doi.org/10.1111/j.1939-1676.2009.0395.x Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA. dhassel@colostate.edu
MeSH Terms
- Animals
- Female
- Gastrointestinal Diseases / blood
- Gastrointestinal Diseases / mortality
- Gastrointestinal Diseases / veterinary
- Horse Diseases / blood
- Horse Diseases / mortality
- Horses
- Hyperglycemia / blood
- Hyperglycemia / veterinary
- Male
- Retrospective Studies
Citations
This article has been cited 8 times.- Gomez DE, Leclere M, Arroyo LG, Li L, John E, Afonso T, Payette F, Darby S. Acute diarrhea in horses: A multicenter Canadian retrospective study (2015 to 2019).. Can Vet J 2022 Oct;63(10):1033-1042.
- Bishop RC, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM. Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic.. Vet Surg 2022 Aug;51(6):891-902.
- Dias DCR, Ribeiro Filho JD, Viana RB, Bittencourt TCC, Dantas FTDR, Teixeira RBC, Di Filippo PA, Manso Filho HC, Alves SR, Santos PVM, Moreira NS. Comparative Trial of Continuous Flow Enteral and Intravenous Fluid Therapy in Horses.. Front Vet Sci 2021;8:686425.
- Vitale V, Berg LC, Larsen BB, Hannesdottir A, Dybdahl Thomsen P, Laursen SH, Verwilghen D, van Galen G. Blood glucose and subcutaneous continuous glucose monitoring in critically ill horses: A pilot study.. PLoS One 2021;16(2):e0247561.
- Bertin FR, Ruffin-Taylor D, Stewart AJ. Insulin dysregulation in horses with systemic inflammatory response syndrome.. J Vet Intern Med 2018 Jul;32(4):1420-1427.
- Urayama S, Arima D, Mizobe F, Shinzaki Y, Nomura M, Minamijima Y, Kusano K. Blood glucose is unlikely to be a prognostic biomarker in acute colitis with systemic inflammatory response syndrome in Thoroughbred racehorses.. J Equine Sci 2018;29(1):15-19.
- Krueger CR, Ruple-Czerniak A, Hackett ES. Evaluation of plasma muscle enzyme activity as an indicator of lesion characteristics and prognosis in horses undergoing celiotomy for acute gastrointestinal pain.. BMC Vet Res 2014;10 Suppl 1(Suppl 1):S7.
- Ohmes CM, Davis EG, Beard LA, Vander Werf KA, Bianco AW, Giger U. Transient Fanconi syndrome in Quarter horses.. Can Vet J 2014 Feb;55(2):147-51.
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