Blood and Peritoneal Lactate, Ratio and Difference, and Peritoneal Lactate to Total Solids Ratio for Detection of Intestinal Strangulating Obstructions in Horses.
Abstract: The effectiveness of the peritoneal fluid L-lactate-to-total solids ratio (PFL:PFTS) as a diagnostic marker for strangulating lesions of the small intestine (SI) and large colon (LC) has not been investigated. Objective: Describe and compare the PFL:PTFS and blood lactate (BL), peritoneal fluid lactate (PFL) and PFL:BL difference and PFL:BL ratio of horses with SI and LC strangulating (SO) and non-strangulating (NSO) obstructions and determine sensitivity and specificity to predict SO. Methods: A total of 282 horses, 117 with SI lesions (59 classified as SINSO and 58 as SISO), and 165 with LC lesions, 126 categorized as LCNSO and 39 as LCSO. Methods: Retrospective study. Receiver operating characteristic (ROC) curves were generated to identify optimal cut-off points to maximize sensitivity and specificity to predict SO. Results: A PFL:PFTS ratio of 2.9 had fair (area under the curve [AUC], 0.76; 95% confidence interval [CI], 0.67-0.84) ability to discriminate between SISO and SINSO, with sensitivity of 66.7% and specificity of 78.3% to predict SISO. Unassigned: PFTS ratio of 3.6 had good ability to discriminate between LCSO and LCNSO (AUC, 0.84; 95% CI, 0.78-0.90) with sensitivity and specificity of 78% and 81% to predict LCSO, respectively. Peritoneal fluid lactate, PFL:BL difference, and PFL:BL ratio also had a low to moderate sensitivity to predict ischemic strangulating lesions of the SI and LC. Conclusions: Strangulating obstructions are critical conditions requiring prompt intervention. The low to moderate sensitivity identified suggests that PFL, PFL:BL difference and ratio, and PFL:PFTS ratio should be interpreted with clinical signs and the response to initial treatment to determine SO accurately.
© 2025 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2025-05-31 PubMed ID: 40448701PubMed Central: PMC12125956DOI: 10.1111/jvim.70121Google Scholar: Lookup
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Summary
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This research examined whether different ratios and differences between levels of peritoneal fluid and blood lactate can accurately predict strangulating obstructions in the small intestine and large colon of horses.
Objective of the Research
- The primary goal of this study was to establish and compare the peritoneal fluid L-lactate-to-total solids ratio (PFL:PFTS) along with the blood lactate (BL), peritoneal fluid lactate (PFL), and the differences and ratios of PFL:BL in horses with either small intestine (SI) or large colon (LC) lesions. These lesions were further classified as either strangulating (SO) or non-strangulating obstructions (NSO).
Methodology
- The researchers used a sample of 282 horses that had been diagnosed with either SI or LC lesions. They then conducted a retrospective study and utilized Receiver Operating Characteristic (ROC) curves to determine the most effective cut-off points for predicting the presence of SO with the greatest sensitivity and specificity.
Results
- The research revealed that a PFL:PFTS ratio of 2.9 was relatively effective at discriminating between strangulating and non-strangulating obstructions in the SI, with 66.7% sensitivity and 78.3% specificity. Similarly, a PFL:PFTS ratio of 3.6 was effective at discriminating between SO and NSO in the LC, with 78% sensitivity and 81% specificity.
- However, the use of peritoneal fluid lactate, the difference between PFL:BL, and the PFL:BL ratio showed only low to moderate sensitivity in predicting the presence of ischemic strangulating lesions in the SI and LC.
Conclusions
- Although the study identified the potential usefulness of these ratios, their sensitivity was low to moderate, meaning they can’t be the only data point to rely on. The results suggest that while PFL and BL measurements, together with their differences and ratios, could provide some information, they should be interpreted in conjunction with clinical signs and initial treatment response for accurate diagnosis of strangulating obstructions in horses.
Cite This Article
APA
Parra-Moyano LA, Cedeño A, Darby S, Johnson JP, Gomez DE.
(2025).
Blood and Peritoneal Lactate, Ratio and Difference, and Peritoneal Lactate to Total Solids Ratio for Detection of Intestinal Strangulating Obstructions in Horses.
J Vet Intern Med, 39(4), e70121.
https://doi.org/10.1111/jvim.70121 Publication
Researcher Affiliations
- Department of Clinical Studies, University of Guelph, Ontario Veterinary College, Guelph, Ontario, Canada.
- Clinica Equina, Vereda la Fagua, Cajicá, Cundinamarca, Colombia.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
- Abu Dhabi Equine and Camel Hospital, Al Wathba, Abu Dhabi, UAE.
- Abu Dhabi Equine and Camel Hospital, Al Wathba, Abu Dhabi, UAE.
MeSH Terms
- Animals
- Horses
- Horse Diseases / diagnosis
- Horse Diseases / blood
- Intestinal Obstruction / veterinary
- Intestinal Obstruction / diagnosis
- Intestinal Obstruction / blood
- Lactic Acid / blood
- Lactic Acid / analysis
- Ascitic Fluid / chemistry
- Retrospective Studies
- Male
- Female
- Sensitivity and Specificity
- ROC Curve
- Biomarkers / blood
Conflict of Interest Statement
The authors declare no conflicts of interest.
References
This article includes 26 references
- Radcliffe RM, Liu SY, Cook VL, Hurcombe SDA, Divers TJ. Interpreting Abdominal Fluid in Colic Horses: Understanding and Applying Peritoneal Fluid Evidence. Journal of Veterinary Emergency and Critical Care (San Antonio) 32, no. S1 (2022): 81–96.
- Kilcoyne I, Dechant JE, Spier SJ, Spriet M, Nieto JE. Clinical Findings and Management of 153 Horses With Large Colon Sand Accumulations. Veterinary Surgery 46, no. 6 (2017): 860–867.
- DeLaurier GA, Cannon RM, Johnson RH. Evaluation of Peritoneal Fluid Lactate as a Marker of Intestinal Ischaemia in Equine Colic. Veterinary Surgery 40, no. 2 (2019): 342–346.
- Yamout SZ, Nieto JE, Beldomenico PM, Dechant JE, leJeune S, Snyder JR. Peritoneal and Plasma D‐Lactate Concentrations in Horses With Colic. Veterinary Surgery 40, no. 7 (2011): 817–824.
- Shearer TR, Norby B, Carr EA. Peritoneal Fluid Lactate Evaluation in Horses With Nonstrangulating Versus Strangulating Small Intestinal Disease. Journal of Equine Veterinary Science 61 (2018): 18–21.
- Latson KM, Nieto JE, Beldomenico PM, Snyder JR. Evaluation of Peritoneal Fluid Lactate as a Marker of Intestinal Ischaemia in Equine Colic. Equine Veterinary Journal 37, no. 4 (2005): 342–346.
- Radcliffe RM, Divers TJ, Fletcher DJ, Mohammed H, Kraus MS. Evaluation of L‐Lactate and Cardiac Troponin I in Horses Undergoing Emergency Abdominal Surgery. Journal of Veterinary Emergency and Critical Care 22, no. 3 (2012): 313–319.
- Delesalle C, Dewulf J, Lefebvre RA. Determination of Lactate Concentrations in Blood Plasma and Peritoneal Fluid in Horses With Colic by an Accusport Analyzer. Journal of Veterinary Internal Medicine 21, no. 2 (2007): 293–301.
- Peloso JG, Cohen ND. Use of Serial Measurements of Peritoneal Fluid Lactate Concentration to Identify Strangulating Intestinal Lesions in Referred Horses With Signs of Colic. Journal of the American Veterinary Medical Association 240, no. 10 (2012): 1208–1217.
- Nieto JE, Dechant JE, le Jeune SS, Snyder JR. Evaluation of 3 Handheld Portable Analyzers for Measurement of L‐Lactate Concentrations in Blood and Peritoneal Fluid of Horses With Colic. Veterinary Surgery 44, no. 3 (2015): 366–372.
- Long AE, Southwood LL, Morris TB, Brandly JE, Stefanovski D. Use of Multiple Admission Variables Better Predicts Intestinal Strangulation in Horses With Colic Than Peritoneal or the Ratio of Peritoneal: Blood l‐Lactate Concentration. Equine Veterinary Journal 56, no. 3 (2024): 437–448.
- Dunkel B, Mason CJ, Chang YM. Retrospective Evaluation of the Association Between Admission Blood Glucose and l‐Lactate Concentrations in Ponies and Horses With Gastrointestinal Disease (2008–2016): 545 Cases. Journal of Veterinary Emergency & Critical Care (San Antonio) 29, no. 4 (2019): 418–423.
- Parry BW, Anderson GA, Gay CC. Prognosis in Equine Colic: A Study of Individual Variables Used in Case Assessment. Equine Veterinary Journal 15, no. 4 (1983): 337–344.
- Kilcoyne I, Nieto JE, Dechant JE. Diagnostic Value of Plasma and Peritoneal Fluid Procalcitonin Concentrations in Horses With Strangulating Intestinal Lesions. Journal of the American Veterinary Medical Association 256, no. 8 (2020): 927–933.
- Pérez MC, Fernández-Sarmiento J, Bustos JD. Association Between the Lactate‐Albumin Ratio and Microcirculation Changes in Pediatric Septic Patients. Scientific Reports 14, no. 1 (2024): 22579.
- Mandrekar JN. Receiver Operating Characteristic Curve in Diagnostic Test Assessment. Journal of Thoracic Oncology 5, no. 9 (2010): 1315–1316.
- DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the Areas Under Two or More Correlated Receiver Operating Characteristic Curves: A Nonparametric Approach. Biometrics 44, no. 3 (1988): 837–845.
- Liao XP, She YX, Shi CR, Li M. Changes in Body Fluid Markers in Intestinal Ischemia. Journal of Pediatric Surgery 30, no. 10 (1995): 1412–1415.
- DeLaurier GA, Cannon RM, Johnson RH, Sisley JF, Baisden CR, Mansberger AR. Increased Peritoneal Fluid Lactic Acid Values and Progressive Bowel Strangulation in Dogs. American Journal of Surgery 158, no. 1 (1989): 32–35.
- DeLaurier GA, Ivey RK, Johnson RH. Peritoneal Fluid Lactic Acid and Diagnostic Dilemmas in Acute Abdominal Disease. American Journal of Surgery 167, no. 3 (1994): 302–305.
- Bonczynski JJ, Ludwig LL, Barton LJ, Loar A, Peterson ME. Comparison of Peritoneal Fluid and Peripheral Blood pH, Bicarbonate, Glucose, and Lactate Concentration as a Diagnostic Tool for Septic Peritonitis in Dogs and Cats. Veterinary Surgery 32, no. 2 (2003): 161–166.
- Levin GM, Bonczynski JJ, Ludwig LL, Barton LJ, Loar AS. Lactate as a Diagnostic Test for Septic Peritoneal Effusions in Dogs and Cats. Journal of the American Animal Hospital Association 40, no. 5 (2004): 364–371.
- Brooks GA. The Science and Translation of Lactate Shuttle Theory. Cell Metabolism 27, no. 4 (2018): 757–785.
- Arroyo LG, Sears W, Gomez DE. Plasma Transfusions in Horses With Typhlocolitis/Colitis. Canadian Veterinary Journal 60, no. 2 (2019): 193–196.
- Vincent JL. Relevance of Albumin in Modern Critical Care Medicine. Best Practice & Research. Clinical Anaesthesiology 23, no. 2 (2009): 183–191.
- Matthews S, Dart AJ, Reid SWJ, Dowling BA, Hodgson DR. Predictive Values, Sensitivity and Specificity of Abdominal Fluid Variables in Determining the Need for Surgery in Horses With an Acute Abdominal Crisis. Australian Veterinary Journal 80, no. 3 (2002): 132–136.
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