Contribution of whole blood L-lactate, pyruvate, D-lactate, acetoacetate, and 3-hydroxybutyrate concentrations to the plasma anion gap in horses with intestinal disorders.

This research investigates what contributes to the increased anion gap (AG) — a measure of acid-base balance — in horses with intestinal problems, finding L-lactic acidosis as a significant factor in all examined cases, with other elements like D-lactate providing a minor but noteworthy contribution in some.

Overview

The study focuses on testing various possible contributors to an elevated anion gap (AG) in horses with intestinal disorders. An AG is a calculation used in medicine to help identify the cause of a patient’s acid-base imbalance. In this situation, horses were used as the patient model, and different substances present in their blood were measured to see which had a significant impact on the AG.

Main Findings

• The primary finding was L-lactic acidosis which was responsible for an increased AG in every single of the 14 horses studied. L-lactic acidosis refers to an elevated level of L-lactate, a form of lactic acid, in the body. In horses with intestinal disorders, their bodies produce more lactic acid as a byproduct of the body’s energy production processes. This excessive accumulation acidifies the body’s internal environment, thereby increasing the AG.
• In a few instances, an increase in the concentration of D-lactate in the whole blood also contributed to the AG. D-lactate is another form of lactic acid which is produced by bacterial fermentation in the colon and can be absorbed into the blood.

Other Element Findings

• The increase in AG often surpassed the combined increases in L-lactate and D-lactate — which cannot be attributed to other measured elements like pyruvate, 3-hydroxybutyrate, acetoacetate, serum albumin, or phosphate. Pyruvate, 3-hydroxybutyrate, and acetoacetate play critical roles in the body’s energy metabolism processes, while serum albumin and phosphate help in maintaining the body’s acid-base balance.
• With the data collected, the research team suggests that unidentified ions could be contributing to the increased AG, and their identification could enhance the understanding, diagnosis, and treatment of metabolic imbalances in critically ill horses.