Association of admission plasma D-dimer concentration with diagnosis and outcome in horses with colic.
Abstract: Coagulopathies detected in horses with gastrointestinal problems seem to be associated with poor outcome. Plasma D-Dimer concentration is a sensitive test for assessing coagulopathies. Objective: Plasma D-Dimer concentration tested on admission is related to diagnosis and outcome in horses with colic. Methods: Four hundred and ninety three horses referred for evaluation of abdominal pain. Methods: Prospective observational clinical study. Horses were grouped according to diagnosis (medical and surgical intestinal obstructions, ischemic disorders with and without intestinal resection, enteritis, peritonitis), outcome (survivors, nonsurvivors), and number of coagulopathies (normal profile, 1 or 2 coagulopathies, subclinical disseminated intravascular coagulation [DIC]). Blood samples were collected on admission and plasma D-Dimer concentration, clotting times (PT and aPTT), and antithrombin activity were determined. Positive likelihood ratios (LR+) were calculated for evaluation of D-Dimer cut-off values, which were later tested in a logistic regression model. Results: Horses with enteritis or peritonitis had significantly (P<.001) higher plasma D-Dimer concentrations and more severe coagulopathies on admission than horses with other diagnoses. Nonsurvivors also had significantly (P<.001) higher plasma D-Dimer concentrations at presentation than did survivors, and those horses with subclinical DIC on presentation had an odds ratio (OR) 8.6 (95% confidence interval [CI], 3.3-22.5, P4,000 ng/mL had a LR+ of 5.9 and an OR 8.8 (95% CI, 4.5-17.1, P<.001) for nonsurvival. Conclusions: Plasma D-Dimer concentration measured on admission can be used to facilitate diagnosis and outcome prediction in horses with colic. A potential cut-off value for nonsurvival was found at approximately 4,000 ng/mL.
Copyright © 2010 by the American College of Veterinary Internal Medicine.
Publication Date: 2010-10-14 PubMed ID: 20946373DOI: 10.1111/j.1939-1676.2010.0618.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The research article investigates how the concentration of plasma D-dimer at admission for horses with colic can help in the diagnosis and prognosis of the disease. High D-dimer concentrations have been linked with severe illness and poor survival rates.
Objective and Methodology
- The research seeks to examine the relevance of plasma D-dimer concentration in diagnosing and predicting the outcome in cases of horse colic.
- A total of 493 horses, referred for abdominal pain evaluation, were studied in a prospective observational clinical trial. Horses were categorized by diagnosis, outcome (survivors or nonsurvivors), and presence of coagulopathies (normal profile, 1 or 2 coagulopathies, subclinical disseminated intravascular coagulation [DIC]).
- Blood samples were collected on admission. They were then tested for plasma D-dimer concentration, clotting times (PT and aPTT), and antithrombin activity.
- A couple of statistical methods, namely positive likelihood ratios (LR+) and a logistic regression model, were used to identify D-dimer cut-off values.
Results
- Horses suffering from enteritis or peritonitis displayed substantially higher plasma D-dimer concentrations and more serious coagulopathies upon admission than horses with different diagnoses.
- Nonsurvivors also presented significantly higher plasma D-dimer concentrations than did survivors.
- Horses diagnosed with subclinical DIC at presentation had an 8.6-fold higher odds of nonsurvival.
- D-dimer concentrations above 4,000 ng/mL were linked to a likelihood ratio of 5.9 indicating increased illness severity and an odds ratio of 8.8 demonstrating reduced survival chances.
Conclusion
- The concentration of plasma D-dimer in horses upon admission is a potentially useful marker for diagnosing gastrointestinal diseases and predicting survival outcomes.
- The critical cut-off value for nonsurvival is approximately 4,000 ng/mL, according to this research. If D-dimer concentrations exceed this level, it suggests a higher risk and severity of disease, and a lower chance of survival.
Cite This Article
APA
Cesarini C, Monreal L, Armengou L, Delgado MÁ, Ríos J, Jose-Cunilleras E.
(2010).
Association of admission plasma D-dimer concentration with diagnosis and outcome in horses with colic.
J Vet Intern Med, 24(6), 1490-1497.
https://doi.org/10.1111/j.1939-1676.2010.0618.x Publication
Researcher Affiliations
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, and the Statistics and Methodology Support Unit, IDIBAPS, Hospital Clínic, Barcelona, Spain.
MeSH Terms
- Animals
- Colic / blood
- Colic / etiology
- Colic / veterinary
- Enteritis / blood
- Enteritis / complications
- Enteritis / veterinary
- Female
- Fibrin Fibrinogen Degradation Products / metabolism
- Horse Diseases / blood
- Horses
- Intestinal Obstruction / blood
- Intestinal Obstruction / veterinary
- Ischemia / blood
- Ischemia / complications
- Ischemia / veterinary
- Likelihood Functions
- Logistic Models
- Male
- Peritonitis / blood
- Peritonitis / veterinary
- Risk Factors
Citations
This article has been cited 12 times.- Blangy-Letheule A, Vergnaud A, Dupas T, Rozec B, Lauzier B, Leroux AA. Spontaneous Sepsis in Adult Horses: From Veterinary to Human Medicine Perspectives. Cells 2023 Mar 30;12(7).
- Honoré ML, Pihl TH, Busk-Anderson TM, Flintrup LL, Nielsen LN. Investigation of two different human d-dimer assays in the horse. BMC Vet Res 2022 Jun 15;18(1):227.
- Honoré ML, Pihl TH, Nielsen LN. A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease. BMC Vet Res 2021 Nov 8;17(1):346.
- Lambertini C, Bombardi C, Zannoni A, Bernardini C, Dondi F, Morini M, Rinnovati R, Spadari A, Romagnoli N. Proteinase Activated Receptor 4 in the Jejunum of Healthy Horses and of Horses With Epiploic Hernia. Front Vet Sci 2020;7:158.
- Barton AK, Wirth C, Bondzio A, Einspanier R, Gehlen H. Are pulmonary hemostasis and fibrinolysis out of balance in equine chronic pneumopathies?. J Vet Sci 2017 Sep 30;18(3):349-357.
- Furness MC, Setlakwe E, Sallaway J, Wood D, Fromstein J, Arroyo LG. Acute myeloid leukemia with basophilic differentiation in a 3-year-old Standardbred gelding. Can Vet J 2016 Oct;57(10):1067-1071.
- Cesarini C, Cotovio M, Ríos J, Armengou L, Jose-Cunilleras E. Association Between Necropsy Evidence of Disseminated Intravascular Coagulation and Hemostatic Variables Before Death in Horses With Colic. J Vet Intern Med 2016 Jan-Feb;30(1):269-75.
- Yang K, Wang W, Zhang WH, Chen XL, Zhou J, Chen XZ, Zhang B, Chen ZX, Zhou ZG, Hu JK. The Combination of D-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis. Medicine (Baltimore) 2015 Oct;94(40):e1564.
- Alonso Jde M, Rodrigues KA, Yamada AL, Watanabe MJ, Alves AL, Rodrigues CA, Hussni CA. Peritoneal reactivity evaluation in horses subjected to experimental small colon enterotomy and treated with subcutaneous heparin. Vet Med Int 2014;2014:385392.
- Schliewert EC, Hooijberg EH, Goddard A. Experimental infection of horses with African horse sickness virus results in overt disseminated intravascular coagulation. Equine Vet J 2026 Mar;58(2):619-629.
- Brown JE, Noormohammadi AH, Courtman NF. Immunoreactivity of canine, feline, and equine D-dimer with antibodies to human D-dimer. J Vet Intern Med 2024 Jan-Feb;38(1):187-196.
- Hajimohammadi A, Ghane M, Ghari Tehrani M, Paravar B, Mirzaei A, Razavi S, Nikzad M. Association of the severity of colic in horses with oxidative stress biomarkers, acute-phase proteins, and certain trace elements. J Equine Sci 2023 Sep;34(3):73-81.
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