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Journal of veterinary internal medicine2014; 28(5); 1587-1593; doi: 10.1111/jvim.12404

Diagnostic and predictive capability of routine laboratory tests for the diagnosis and staging of equine inflammatory disease.

Abstract: A wide spectrum of laboratory tests is available to aid diagnosis and classification of equine inflammatory disease. Objective: To compare diagnostic efficacy and combined predictive capability of the myeloperoxidase index (MPXI), and plasma fibrinogen, iron and serum amyloid A (SAA) concentrations for the diagnosis of inflammation. Methods: Twenty-six hospitalized horses with systemic inflammation (SI), 114 with local inflammation (LI) and 61 healthy horses or those with noninflammatory disease (NI) were included. Methods: A retrospective study was performed; clinicopathologic data from horses were compared between groups. Receiver-operator characteristic (ROC) curves were used to evaluate diagnostic efficacy; classification and regression tree analysis (CART) and logistic regression analysis were used to generate diagnostic algorithms. Results: Horses with SI had significantly higher SAA than horses with LI (P = .007) and NI (P < .001) and lower iron concentrations than horses with LI (P < .001) and NI (P < .001). Fibrinogen concentration was higher in horses with inflammation than in those without inflammation (P = .002). There was no difference between the SI and LI groups. White blood cell count, neutrophil count and MPXI were similar between groups. SAA had the highest accuracy for diagnosing inflammation (area under ROC curve [AUC], 0.83 ± 0.06) and iron and SAA concentration had the highest accuracy for differentiating SI from LI (AUC, 0.80 ± 0.09 and 0.73 ± 0.10 respectively). Predictive modeling failed to generate useful algorithms and classification of cases was moderate. Conclusions: Very high SAA and low iron concentrations may reflect SI, but diagnostic guidelines based on quantitative results of inflammatory markers could not be formulated.
Copyright © 2014 by the American College of Veterinary Internal Medicine.
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Publication Date: 2014-07-23 PubMed ID: 25056342PubMed Central: PMC4895560DOI: 10.1111/jvim.12404Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study evaluates the efficacy of various laboratory tests, focusing on specific biomarkers, for accurately diagnosing inflammation in horses. Although some markers show promise, the findings suggest that current predictive models are insufficient for formulating standardized diagnostic guidelines for equine inflammatory diseases.

Research Objectives and Methods

  • The main focus of this study was to assess the diagnostic effectiveness and combined predictive capacity of the myeloperoxidase index (MPXI), plasma fibrinogen, iron and serum amyloid A (SAA) concentrations for identifying inflammation in horses.
  • It involved a total of 201 horses which were segregated into three groups for the purpose of the study: 26 horses with systemic inflammation (SI), 114 with local inflammation (LI), and 61 horses identified as healthy or suffering from noninflammatory disease (NI).
  • The research employed a retrospective design, comparing clinicopathological data from each group of horses. To determine the diagnostic efficacy of the parameters being studied, the researchers utilized receiver-operator characteristic (ROC) curves. For generation of diagnostic algorithms, they used classification and regression tree analysis (CART) and logistic regression analysis.

Research Findings

  • The results showed that horses with SI had significantly higher serum amyloid A (SAA) concentrations compared to the horses in the LI and NI groups. On the other hand, iron concentrations in SI horses were notably lower than those measured in the LI and NI groups.
  • Fibrinogen concentration, another potential inflammatory marker, was found to be higher in horses with inflammation, whether systemic or local, in comparison to those without inflammation.
  • White blood cell count, neutrophil count, and MPXI—that were also evaluated for their correlation with inflammation—showed no significant variations across the three groups.
  • Among all parameters, SAA proved to be the most accurate for diagnosing inflammation while both iron and SAA concentrations were most accurate when differentiating systemic from local inflammation.
  • Despite these findings, the predictive modeling performed using CART and logistic regression failed to yield practical algorithms. Subsequently, the classification of cases based on these models was only moderate.

Conclusions

  • The research concluded that very high SAA and low iron concentrations may be indicative of systemic inflammation in horses.
  • Despite this, the study suggests that diagnostic protocols based on quantitative results of inflammatory markers could not be successfully established with the currently available predictive models.

Cite This Article

APA
Hooijberg EH, van den Hoven R, Tichy A, Schwendenwein I. (2014). Diagnostic and predictive capability of routine laboratory tests for the diagnosis and staging of equine inflammatory disease. J Vet Intern Med, 28(5), 1587-1593. https://doi.org/10.1111/jvim.12404

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 28
Issue: 5
Pages: 1587-1593

Researcher Affiliations

Hooijberg, E H
  • Platform for Clinical Pathology, University of Veterinary Medicine, Vienna, Austria.
van den Hoven, R
    Tichy, A
      Schwendenwein, I

        MeSH Terms

        • Animals
        • Female
        • Fibrinogen / analysis
        • Horse Diseases / blood
        • Horse Diseases / diagnosis
        • Horses
        • Inflammation / blood
        • Inflammation / diagnosis
        • Inflammation / veterinary
        • Iron / blood
        • Male
        • Peroxidase / blood
        • Predictive Value of Tests
        • Retrospective Studies
        • Serum Amyloid A Protein / analysis
        • Systemic Inflammatory Response Syndrome / blood
        • Systemic Inflammatory Response Syndrome / diagnosis
        • Systemic Inflammatory Response Syndrome / veterinary

        References

        This article includes 29 references
        1. Ackerman MR. Acute inflammation. 2007:101–152.
        2. Carr EA. The systemic inflammatory response syndrome. 2009:862–866.
        3. Jacobsen S, Andersen PH. The acute phase protein serum amyloid a (SAA) as a marker of inflammation in horses. Equine Vet Edu 2007;19:38–46.
        4. Jacobsen S, Jensen JC, Frei S, Jensen AL, Thoefner MB. Use of serum amyloid A and other acute phase reactants to monitor the inflammatory response after castration in horses: a field study.. Equine Vet J 2005 Nov;37(6):552-6.
          pubmed: 16295934doi: 10.2746/042516405775314853google scholar: lookup
        5. Hultén C, Demmers S. Serum amyloid A (SAA) as an aid in the management of infectious disease in the foal: comparison with total leucocyte count, neutrophil count and fibrinogen.. Equine Vet J 2002 Nov;34(7):693-8.
          pubmed: 12455840doi: 10.2746/042516402776250360google scholar: lookup
        6. Schwarz BC, van den Hoven R, Schwendenwein I. Diagnostic value of the neutrophil myeloperoxidase index in horses with systemic inflammation.. Vet J 2012 Jan;191(1):72-8.
          pubmed: 21262582doi: 10.1016/j.tvjl.2010.12.010google scholar: lookup
        7. Piviani M, Segura D, Monreal L, Bach-Raich E, Mesalles M, Pastor J. Neutrophilic myeloperoxidase index and mean light absorbance in neonatal septic and nonseptic foals.. Vet Clin Pathol 2011 Sep;40(3):340-4.
          pubmed: 21827520doi: 10.1111/j.1939-165x.2011.00343.xgoogle scholar: lookup
        8. Crisman MV, Scarratt WK, Zimmerman KL. Blood proteins and inflammation in the horse.. Vet Clin North Am Equine Pract 2008 Aug;24(2):285-97, vi.
          pubmed: 18652956doi: 10.1016/j.cveq.2008.03.004google scholar: lookup
        9. Smith JE, Cipriano JE. Inflammation-induced changes in serum iron analytes and ceruloplasmin of Shetland ponies.. Vet Pathol 1987 Jul;24(4):354-6.
          pubmed: 3617401doi: 10.1177/030098588702400411google scholar: lookup
        10. Borges AS, Divers TJ, Stokol T, Mohammed OH. Serum iron and plasma fibrinogen concentrations as indicators of systemic inflammatory diseases in horses.. J Vet Intern Med 2007 May-Jun;21(3):489-94.
          pubmed: 17552456doi: 10.1892/0891-6640(2007)21[489:siapfc]2.0.co;2google scholar: lookup
        11. Jacobsen S, Nielsen JV, Kjelgaard-Hansen M, Toelboell T, Fjeldborg J, Halling-Thomsen M, Martinussen T, Thoefner MB. Acute phase response to surgery of varying intensity in horses: a preliminary study.. Vet Surg 2009 Aug;38(6):762-9.
          pubmed: 19674420doi: 10.1111/j.1532-950x.2009.00564.xgoogle scholar: lookup
        12. Swancar‐Haid P. Implementierung eines serum amyloid A (SAA) assays—als früher Marker entzündlicher Erkrankungen beim Pferd. 2011.
        13. Gardner IA, Greiner M. Receiver-operating characteristic curves and likelihood ratios: improvements over traditional methods for the evaluation and application of veterinary clinical pathology tests.. Vet Clin Pathol 2006 Mar;35(1):8-17.
          pubmed: 16511785doi: 10.1111/j.1939-165x.2006.tb00082.xgoogle scholar: lookup
        14. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.. Biometrics 1988 Sep;44(3):837-45.
          pubmed: 3203132
        15. Jensen AL, Poulsen JS. Evaluation of diagnostic tests using relative operating characteristic (ROC) curves and the differential positive rate. An example using the total serum bile acid concentration and the alanine aminotransferase activity in the diagnosis of canine hepatobiliary diseases.. Zentralbl Veterinarmed A 1992 Nov;39(9):656-68.
          pubmed: 1455934doi: 10.1111/j.1439-0442.1992.tb00231.xgoogle scholar: lookup
        16. Stärk KDC, Pfeiffer DU. The application of non‐parametric techniques to solve classification problems in complex data sets in veterinary epidemiology—An example. Intell Data Anal 1999;3:23–35.
        17. Casella S, Fazio F, Giannetto C, Giudice E, Piccione G. Influence of transportation on serum concentrations of acute phase proteins in horse.. Res Vet Sci 2012 Oct;93(2):914-7.
          pubmed: 22296939doi: 10.1016/j.rvsc.2012.01.004google scholar: lookup
        18. Andersen SA, Petersen HH, Ersbøll AK, Falk-Rønne J, Jacobsen S. Vaccination elicits a prominent acute phase response in horses.. Vet J 2012 Feb;191(2):199-202.
          pubmed: 21371917doi: 10.1016/j.tvjl.2011.01.019google scholar: lookup
        19. Belgrave RL, Dickey MM, Arheart KL, Cray C. Assessment of serum amyloid A testing of horses and its clinical application in a specialized equine practice.. J Am Vet Med Assoc 2013 Jul 1;243(1):113-9.
          pubmed: 23786199doi: 10.2460/javma.243.1.113google scholar: lookup
        20. Wessling-Resnick M. Iron homeostasis and the inflammatory response.. Annu Rev Nutr 2010 Aug 21;30:105-22.
          pmc: PMC3108097pubmed: 20420524doi: 10.1146/annurev.nutr.012809.104804google scholar: lookup
        21. Brosnahan MM, Erb HN, Perkins GA, Divers TJ, Borges AS, Osterrieder N. Serum iron parameters and acute experimental EHV-1 infection in horses.. J Vet Intern Med 2012 Sep-Oct;26(5):1232-5.
          pubmed: 22748124doi: 10.1111/j.1939-1676.2012.00963.xgoogle scholar: lookup
        22. Cray C, Zaias J, Altman NH. Acute phase response in animals: a review.. Comp Med 2009 Dec;59(6):517-26.
          pmc: PMC2798837pubmed: 20034426
        23. Cohen ND, Chaffin MK, Vandenplas ML, Edwards RF, Nevill M, Moore JN, Martens RJ. Study of serum amyloid A concentrations as a means of achieving early diagnosis of Rhodococcus equi pneumonia.. Equine Vet J 2005 May;37(3):212-6.
          pubmed: 15892228doi: 10.2746/0425164054530704google scholar: lookup
        24. Copas VE, Durham AE, Stratford CH, McGorum BC, Waggett B, Pirie RS. In equine grass sickness, serum amyloid A and fibrinogen are elevated, and can aid differential diagnosis from non-inflammatory causes of colic.. Vet Rec 2013 Apr 13;172(15):395.
          pubmed: 23428423doi: 10.1136/vr.101224google scholar: lookup
        25. Pollock PJ, Prendergast M, Schumacher J, Bellenger CR. Effects of surgery on the acute phase response in clinically normal and diseased horses.. Vet Rec 2005 Apr 23;156(17):538-42.
          pubmed: 15849343doi: 10.1136/vr.156.17.538google scholar: lookup
        26. Eckersall PD, Bell R. Acute phase proteins: Biomarkers of infection and inflammation in veterinary medicine.. Vet J 2010 Jul;185(1):23-7.
          pubmed: 20621712doi: 10.1016/j.tvjl.2010.04.009google scholar: lookup
        27. d'Eril GM, Anesi A, Maggiore M, Leoni V. Biological variation of serum amyloid A in healthy subjects.. Clin Chem 2001 Aug;47(8):1498-9.
          pubmed: 11468251
        28. Porter RS, Leblond A, Lecollinet S, Tritz P, Cantile C, Kutasi O, Zientara S, Pradier S, van Galen G, Speybroek N, Saegerman C. Clinical diagnosis of West Nile Fever in Equids by classification and regression tree (CART) analysis and comparative study of clinical appearance in three European countries.. Transbound Emerg Dis 2011 Jun;58(3):197-205.
          pubmed: 21208395doi: 10.1111/j.1865-1682.2010.01196.xgoogle scholar: lookup
        29. Kirtz G, Leschnik M, Hooijberg E, Tichy A, Leidinger E. In-clinic laboratory diagnosis of canine babesiosis (Babesia canis canis) for veterinary practitioners in Central Europe.. Tierarztl Prax Ausg K Kleintiere Heimtiere 2012 Apr 24;40(2):87-94.
          pubmed: 22526812

        Citations

        This article has been cited 9 times.
        1. Ehrmann C, Engel J, Moritz A, Roscher K. Assessment of platelet biology in equine patients with systemic inflammatory response syndrome. J Vet Diagn Invest 2021 Mar;33(2):300-307.
          doi: 10.1177/1040638720983791pubmed: 33353486google scholar: lookup
        2. Sinovich M, Villarino NF, Singer E, Robinson CS, Rubio-Martínez LM. Can blood serum amyloid A concentrations in horses differentiate synovial sepsis from extrasynovial inflammation and determine response to treatment?. Vet Rec 2020 Sep 19;187(6):235.
          doi: 10.1136/vr.105153pubmed: 32098906google scholar: lookup
        3. Long A, Nolen-Walston R. Equine Inflammatory Markers in the Twenty-First Century: A Focus on Serum Amyloid A. Vet Clin North Am Equine Pract 2020 Apr;36(1):147-160.
          doi: 10.1016/j.cveq.2019.12.005pubmed: 32007299google scholar: lookup
        4. Hooijberg EH, Cray C, Steenkamp G, Buss P, Goddard A, Miller M. Assessment of the Acute Phase Response in Healthy and Injured Southern White Rhinoceros (Ceratotherium simum simum). Front Vet Sci 2019;6:475.
          doi: 10.3389/fvets.2019.00475pubmed: 31998761google scholar: lookup
        5. Junkkari R, Simojoki H, Heiskanen ML, Pelkonen S, Sankari S, Tulamo RM, Mykkänen A. A comparison of unheated loose housing with stables on the respiratory health of weaned-foals in cold winter conditions: an observational field-study. Acta Vet Scand 2017 Oct 26;59(1):73.
          doi: 10.1186/s13028-017-0339-3pubmed: 29073941google scholar: lookup
        6. Vinther AM, Heegaard PM, Skovgaard K, Buhl R, Andreassen SM, Andersen PH. Characterization and differentiation of equine experimental local and early systemic inflammation by expression responses of inflammation-related genes in peripheral blood leukocytes. BMC Vet Res 2016 Jun 1;12:83.
          doi: 10.1186/s12917-016-0706-8pubmed: 27250718google scholar: lookup
        7. Leidinger EF, Leidinger J, Figl J, Rumpler B, Schwendenwein I. Application of the ASVCP guidelines for the establishment of haematologic and biochemical reference intervals in Icelandic horses in Austria. Acta Vet Scand 2015 Jun 14;57(1):30.
          doi: 10.1186/s13028-015-0120-4pubmed: 26070944google scholar: lookup
        8. Friend MM, McGaffigan EM, Hall SM, Staniar WB, Smarsh DN. Changes in equine complete blood count parameters and inflammatory indices with inflammation. J Equine Vet Sci 2025 Dec;155:105705.
          doi: 10.1016/j.jevs.2025.105705pubmed: 41043566google scholar: lookup
        9. Laves J, Wergin M, Bauer N, Müller SF, Failing K, Büttner K, Hagen A, Melzer M, Röcken M. The effect of Traumeel LT ad us. vet. on the perioperative inflammatory response after castration of stallions: a prospective, randomized, double-blinded study. Front Vet Sci 2024;11:1342345.
          doi: 10.3389/fvets.2024.1342345pubmed: 39415958google scholar: lookup
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