Physicochemical interpretation of acid-base abnormalities in 54 adult horses with acute severe colitis and diarrhea.
Abstract: The quantitative effect of strong electrolytes, pCO2 , and plasma protein concentration in determining plasma pH and bicarbonate concentrations can be demonstrated with the physicochemical approach. Plasma anion gap (AG) and strong ion gap (SIG) are used to assess the presence or absence of unmeasured anions. Objective: The physicochemical approach is useful for detection and explanation of acid-base disorders in horses with colitis. AG and SIG accurately predict hyperlactatemia in horses with colitis. Methods: Fifty-four horses with acute colitis and diarrhea. Methods: Retrospective study. Physicochemical variables were calculated for each patient. ROC curves were generated to analyze sensitivity and specificity of AG and SIG for predicting hyperlactatemia. Results: Physicochemical interpretation of acid-base events indicated that strong ion metabolic acidosis was present in 39 (72%) horses. Mixed strong ion acidosis and decreased weak acid (hypoproteinemia) alkalosis was concomitantly present in 17 (30%) patients. The sensitivity and specificity of AG and SIG to predict hyperlactatemia (L-lactate > 5 mEq/L) were 100% (95% CI, 66.4-100; P < .0001) and 84.4% (95% CI, 70.5-93.5 P < .0001). Area under the ROC curve for AG and SIG for predicting hyperlactatemia was 0.95 (95% CI, 0.86-0.99) and 0.93 (95% CI, 0.83-0.99), respectively. Conclusions: These results emphasize the importance of strong ions and proteins in the maintenance of the acid-base equilibria. AG and SIG were considered good predictors of clinically relevant hyperlactatemia.
Copyright © 2013 by the American College of Veterinary Internal Medicine.
Publication Date: 2013-04-03 PubMed ID: 23551698DOI: 10.1111/jvim.12071Google Scholar: Lookup
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- Journal Article
Summary
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This research study aims to explain the effect of variables such as strong electrolytes, pCO2, and plasma protein concentration on the plasma pH and bicarbonate concentrations in horses with acute colitis using a physicochemical approach. The results showed that strong ion metabolic acidosis was present in many of the horses, and the plasma anion gap (AG) and strong ion gap (SIG) measurements were effective in predicting a high level of lactate in the blood, or hyperlactatemia.
Research Objectives and Methodology
- The main objective of this study was to investigate the value of the physicochemical approach in identifying and explaining acid-base imbalances in horses suffering from acute colitis. This approach uses variables like electrolytes, pCO2, and plasma protein concentration to determine plasma pH and bicarbonate concentration.
- The researchers conducted a retrospective study that involved 54 adult horses diagnosed with acute colitis and diarrhea. They calculated physicochemical variables for each patient and used the measurements of AG and SIG to predict the presence of hyperlactatemia (an excess level of lactate in the blood).
- The sensitivity and specificity of AG and SIG as indicators were analyzed using Receiver Operating Characteristic (ROC) curves. The area under the ROC curve was used to determine the accuracy of these indices in predicting hyperlactatemia.
Study Findings
- The results showed that 72% of the horses had strong ion metabolic acidosis, a condition where the body either produces too much acid or the kidneys are not removing enough acid from the body.
- There was a concurrent presence of mixed strong ion acidosis and decreased weak acid (hypoproteinemia) alkalosis in 30% of the patients. This suggests the acid-base equilibrium in these horses was effected both by heightened ion acidosis and decreased protein levels.
- The sensitivity and specificity of the AG and SIG in predicting hyperlactatemia were found to be 100% and 84.4% respectively, showing a high accuracy in these indicators for confirming the disorder.
Conclusion
- These results highlight the significant role of strong ions and proteins in maintaining the acid-base balance in the body. It suggests that AG and SIG can serve as reliable predictors of clinically relevant hyperlactatemia in horses with acute colitis.
- The findings of this research could help vets better understand, diagnose, and treat acid-base abnormalities in horses with acute severe colitis and diarrhea using the physicochemical approach.
Cite This Article
APA
Gomez DE, Arroyo LG, Stämpfli HR, Cruz LE, Oliver OJ.
(2013).
Physicochemical interpretation of acid-base abnormalities in 54 adult horses with acute severe colitis and diarrhea.
J Vet Intern Med, 27(3), 548-553.
https://doi.org/10.1111/jvim.12071 Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada. dgomez@upei.ca
MeSH Terms
- Acid-Base Equilibrium
- Acid-Base Imbalance / veterinary
- Animals
- Colitis / blood
- Colitis / veterinary
- Diarrhea / blood
- Diarrhea / veterinary
- Female
- Horse Diseases / blood
- Horses
- Male
- Water-Electrolyte Balance
Citations
This article has been cited 15 times.- Gomez DE, Kopper JJ, Byrne DP, Renaud DL, Schoster A, Dunkel B, Arroyo LG, Mykkanen A, Gilsenan WF, Pihl TH, Lopez-Navarro G, Tennent-Brown BS, Hostnik LD, Mora-Pereira M, Marques F, Gold JR, DeNotta SL, Desjardins I, Stewart AJ, Kuroda T, Schaefer E, Oliver-Espinosa OJ, Agne GF, Uberti B, Veiras P, Delph Miller KM, Gialleti R, John E, Toribio RE. Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study. PLoS One 2024;19(11):e0313783.
- Haywood LMB, Sheahan BJ. A Review of Epithelial Ion Transporters and Their Roles in Equine Infectious Colitis. Vet Sci 2024 Oct 7;11(10).
- Monteiro LC, Costa CM, Ermita PAN, Júnior SJPG, Mattos FS, Mansur FC, Dos Santos MO, Alves SR, Mafort EG, Fidélis CF, Avanza MFB, Teixeira RBC, Viana RB, Filho JDR. Treatment of experimental hyperchloremic metabolic acidosis in horses with enteral electrolyte solution containing sodium acetate. Front Vet Sci 2024;11:1376578.
- Giraldo AF, Carballo R, Serrenho RC, Tran V, Valverde A, Renaud DL, Gomez DE. Association of the type of metabolic acidosis and non-survival of horses with colitis. Can Vet J 2023 Nov;64(11):1044-1050.
- Ayoub C, Arroyo LG, MacNicol JL, Renaud D, Weese JS, Gomez DE. Fecal microbiota of horses with colitis and its association with laminitis and survival during hospitalization. J Vet Intern Med 2022 Nov;36(6):2213-2223.
- Gomez DE, Leclere M, Arroyo LG, Li L, John E, Afonso T, Payette F, Darby S. Acute diarrhea in horses: A multicenter Canadian retrospective study (2015 to 2019). Can Vet J 2022 Oct;63(10):1033-1042.
- Uzal FA, Arroyo LG, Navarro MA, Gomez DE, Asín J, Henderson E. Bacterial and viral enterocolitis in horses: a review. J Vet Diagn Invest 2022 May;34(3):354-375.
- Arroyo LG, Moore A, Bedford S, Gomez DE, Teymournejad O, Xiong Q, Budachetri K, Bekebrede H, Rikihisa Y, Baird JD. Potomac horse fever in Ontario: Clinical, geographic, and diagnostic aspects. Can Vet J 2021 Jun;62(6):622-628.
- Gomez DE, Bedford S, Darby S, Palmisano M, MacKay RJ, Renaud DL. Acid-base disorders in sick goats and their association with mortality: A simplified strong ion difference approach. J Vet Intern Med 2020 Nov;34(6):2776-2786.
- Gomez DE, Buczinski S, Darby S, Palmisano M, Beatty SSK, Mackay RJ. Agreement of 2 electrolyte analyzers for identifying electrolyte and acid-base disorders in sick horses. J Vet Intern Med 2020 Nov;34(6):2758-2766.
- Kirsch K, Sandersen C. Traditional and quantitative analysis of acid-base and electrolyte imbalances in horses competing in cross-country competitions at 2-star to 5-star level. J Vet Intern Med 2020 Mar;34(2):909-921.
- DeNotta SL, Divers TJ. Clinical Pathology in the Adult Sick Horse: The Gastrointestinal System and Liver. Vet Clin North Am Equine Pract 2020 Apr;36(1):105-120.
- Gomez DE, Lofstedt J, Arroyo LG, Wichtel M, Muirhead T, Stämpfli H, McClure JT. Association of unmeasured strong ions with outcome of hospitalized beef and dairy diarrheic calves. Can Vet J 2017 Oct;58(10):1086-1092.
- Gomez DE, Biermann NM, Sanchez LC. Physicochemical Approach to Determine the Mechanism for Acid-Base Disorders in 793 Hospitalized Foals. J Vet Intern Med 2015 Sep-Oct;29(5):1395-402.
- Gomez DE, Lofstedt J, Stämpfli HR, Wichtel M, Muirhead T, McClure JT. Contribution of unmeasured anions to acid-base disorders and its association with altered demeanor in 264 calves with neonatal diarrhea. J Vet Intern Med 2013 Nov-Dec;27(6):1604-12.
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