Fibrinolytic activity in plasma from horses with gastrointestinal diseases: changes associated with diagnosis, surgery, and outcome.

The research article studies changes in blood-clot breakdown (fibrinolytic) activity in horses suffering from acute gastrointestinal diseases. Researchers observed these activities over five days and found that horses with persistently increased levels of a specific clotting inhibitor (PAI-1) had a poorer survival prognosis.

Study Setup

• The research was conducted on 59 horses suffering from acute gastrointestinal diseases admitted to the Large Animal Teaching Hospital over five consecutive days.
• To ensure consistency, only horses that remained hospitalized for at least five days were included in the study.
• Two key enzymes related to fibrinolysis, tissue plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1), were quantified using standard chromogenic activity assays.

Impact of Disease and Surgical Intervention

• Researchers found that PAI-1 activity, the key enzyme that inhibits fibrinolysis, was significantly higher on days 2, 4, and 5 in horses that died, compared to those that were discharged from the hospital.
• They also noted that horses which had undergone surgery had higher PAI-1 activity on days 2 and 3 compared to those that did not, indicating a response to surgical intervention.
• Horses with strangulating intestinal lesions displayed higher PAI-1 activity on the third day, while horses with inflammatory conditions had higher PAI-1 activity at the time of admission compared to those with other types of lesions.

Prognostic Insights

• A significant finding of the study is the potential use of PAI-1 activity as a prognostic tool. Across all horses, those with persistently increased PAI-1 activity had a poorer prognosis for survival. This implies failure of treatment and loss of control over blood clotting.
• In all horses, they observed higher PAI-1 and lower tPA activity on the second day, compared to the rest of the hospital stay. This suggests that fibrinolysis inhibition occurs early in the course of gastrointestinal diseases and in response to surgery.

Concluding Insights

• The results of this study are pivotal as they provide valuable insights into the pathophysiology of acute gastrointestinal diseases in horses.
• Furthermore, they also indicate potential clinical markers like PAI-1 and tPA activity that could assist in the prognosis, treatment planning and disease progress monitoring in horses with gastrointestinal afflictions.