Hepatic and metabolic changes in surgical colic patients: a pilot study.

The research is a pilot study probing hepatic and metabolic changes in surgical colic patients, measuring blood ammonia, bile acid, bilirubin, triglyceride, and glucose concentrations and liver enzyme activities during and after operation, and relating these changes to patient survival.

Objective and Method

• The aim of this study was twofold. First, it sought to determine the changes in blood ammonia, bile acid (BA), bilirubin, triglyceride, and glucose concentrations and liver enzyme activities in perioperative colic patients. Second, it examined the association between these laboratory findings and short-term survival.
• The study implemented a prospective observational clinical methodology. The research subjects were 32 adult horses undergoing exploratory celiotomy for colic. Blood samples were collected before surgery and at two postoperative intervals (24-36 hours and 72-84 hours) for analysis.

Findings

• Preoperative blood tests revealed mildly increased blood ammonia concentrations in two horses. However, postoperative blood ammonia concentrations were within expected ranges for all horses.
• Increases were observed in liver enzyme activities, along with elevations in BA, triglyceride, and total bilirubin concentrations.
• Horses with notably increased admission BA concentrations and sorbitol dehydrogenase (SDH) activities did not survive. Both BA concentrations and SDH activities went down postoperatively.
• Gamma glutamyl transferase (GGT) activity showed no correlation with survival; however, GGT activity remained elevated after the surgery.
• Blood triglyceride concentration was higher in almost all horses postoperation. Differences became evident with regard to survival – horses that did not survive presented higher triglyceride concentrations 24-36 hours postoperatively compared to horses that survived.

Conclusion

• The results of the study enlighten us about the commonality of alterations in metabolism and hepatobiliary function in colic patients. It also provides pivotal prognostic indices for colic patients and highlights areas for improvement in patient management.