Evaluation of systemic inflammatory response syndrome criteria in horses with colic associated with acute gastrointestinal disease.

Overview

• This study investigated the presence of systemic inflammatory response syndrome (SIRS) in horses with acute gastrointestinal disease causing colic.
• It assessed how SIRS relates to survival outcomes and evaluated specific clinical and laboratory indicators as prognostic tools to improve early diagnosis and treatment decisions.

Background

• Systemic inflammatory response syndrome (SIRS) is a critical condition involving widespread inflammation that often complicates serious diseases.
• In horses, SIRS is frequently observed in cases of acute gastrointestinal disorders associated with colic, which can lead to high rates of organ failure and death.
• Early recognition of SIRS and accurate prognostic markers are necessary for better clinical management and improving survival chances.

Study Objectives

• To determine how often SIRS occurs in adult horses admitted with colic due to acute gastrointestinal problems.
• To examine the relationship between the presence of SIRS and patient outcomes (survival vs non-survival).
• To identify specific clinical and laboratory variables that might serve as useful prognostic indicators in these horses.

Methods

• A total of 41 adult horses admitted to a veterinary hospital for acute gastrointestinal disease accompanied by colic were included.
• At admission, clinical data (temperature, heart rate, respiratory rate, mucous membrane characteristics) and laboratory data (white blood cell count, blood lactate concentration) were collected.
• A SIRS score from 0 to 6 was calculated based on these parameters.
• Horses scoring 2 or more were classified as SIRS-positive, while those scoring less were SIRS-negative.
• Outcomes were categorized as survivors (SUR) or non-survivors (NSUR).
• Statistical analyses included group comparisons and linear regression to explore associations between variables and survival time.

Key Findings

• SIRS was detected in 58.5% (24 out of 41) of horses with acute gastrointestinal colic.
• The mortality rate was significantly higher in the SIRS-positive group (50%) compared to the SIRS-negative group (11.7%).
• SIRS-positive horses exhibited:
  • Elevated heart rates
  • Increased respiratory rates
  • Significant eosinopenia (reduced eosinophil counts)
• Within the SIRS-positive group, non-surviving horses had significantly higher blood lactate concentrations compared to survivors, indicating poor prognosis associated with elevated lactate.
• Linear regression analysis showed an inverse relationship between eosinophil count and survival time, meaning higher eosinophil levels were linked to shorter survival durations.

Conclusions and Implications

• The presence of SIRS in horses with acute gastrointestinal disease is strongly associated with higher mortality risk.
• Blood lactate concentration, a marker of tissue hypoxia and inflammation, along with eosinophil count, are valuable prognostic indicators when assessing horses with colic.
• Combining SIRS scoring with targeted laboratory tests can aid veterinarians in early risk stratification and informed clinical decision-making in emergency equine medicine.
• Further prospective research with larger populations is necessary to validate these findings and refine prognostic tools.