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Veterinary surgery : VS2020; 49(3); 472-479; doi: 10.1111/vsu.13361

Prognostic value of colonic and peripheral venous lactate measurements in horses with large colon volvulus.

Abstract: To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy. Methods: Prospective clinical study. Methods: Forty adult horses in which large colon volvulus was diagnosed intraoperatively. Methods: Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant. Results: No association was found between colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large colon volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome. Conclusions: Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners. Conclusions: Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.
© 2020 The American College of Veterinary Surgeons.
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Publication Date: 2020-01-09 PubMed ID: 31916608PubMed Central: PMC8984623DOI: 10.1111/vsu.13361Google Scholar: Lookup
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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 explores the predictive value of various lactate measurements and biopsies for determining the prognosis of horses with large colon volvulus, revealing peripheral lactate values and certain biopsy measurements can provide crucial prognostic information.

Research Approach

The researchers undertook a prospective clinical study involving forty adult horses diagnosed with large colon volvulus. They aimed to determine the prognostic value of the following:

  • Colonic venous lactate values and peripheral lactate values before and after manual correction of the colon volvulus
  • A combination of variables including pelvic flexure biopsy

Both colonic venous and arterial blood samples, as well as peripheral blood samples, were collected from the horses to measure lactate levels both prior and subsequent to the manual correction. Additionally, mucosal biopsy samples were taken in instances where enterotomy or colonic resection and anastomosis were performed.

Methods and Scoring

The researchers used two specific biopsy measurements— the interstitium to crypt (I:C) ratio and hemorrhage scores. Optimal cutoff values were established through a method called receiver operator curve analysis. Correlations between variables and short-term outcome (defined as the horses being discharged from the hospital) were analyzed using univariable regression. The study set significance at P ≤ .05.

Results and Conclusion

The study did not find a significant association between the colonic venous lactate values and the short-term outcomes. However, peripheral venous lactate at admission levels of ≥3.2 mmol/L, after manual correction levels of ≥5 mmol/L and arterial lactate after manual correction ≥3.53 mmol/L, were associated with poor short-term outcomes. Similarly, histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio >1 were also linked to unfavorable short-term results, indicating the importance of these factors in predicting prognosis.

The researchers concluded that peripheral lactate values, the I:C ratio, and the hemorrhage score provided prognostic information that could inform recommendations to horse owners. More specifically, peripheral lactate values after manual correction offer crucial intraoperative diagnostic details that aid in predicting the case outcome in the operative and immediately postoperative period.

Cite This Article

APA
Orr KE, Baker WT, Lynch TM, Hughes FE, Clark CK, Slone DE, Fogle CA, Gonzalez LM. (2020). Prognostic value of colonic and peripheral venous lactate measurements in horses with large colon volvulus. Vet Surg, 49(3), 472-479. https://doi.org/10.1111/vsu.13361

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 49
Issue: 3
Pages: 472-479

Researcher Affiliations

Orr, Kindra E
  • Peterson and Smith Equine Hospital, Ocala, Florida.
Baker, W True
  • Hagyard Equine Medical Institute, Lexington, Kentucky.
Lynch, Tim M
  • Peterson and Smith Equine Hospital, Ocala, Florida.
Hughes, Faith E
  • Peterson and Smith Equine Hospital, Ocala, Florida.
Clark, Carol K
  • Peterson and Smith Equine Hospital, Ocala, Florida.
Slone, Donnie E
  • Peterson and Smith Equine Hospital, Ocala, Florida.
Fogle, Callie A
  • North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina.
Gonzalez, Liara M
  • North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina.

MeSH Terms

  • Animals
  • Biopsy / veterinary
  • Blood Gas Analysis / veterinary
  • Colon / pathology
  • Female
  • Hemorrhage / pathology
  • Horse Diseases / blood
  • Horse Diseases / diagnosis
  • Horse Diseases / therapy
  • Horses
  • Intestinal Volvulus / blood
  • Intestinal Volvulus / diagnosis
  • Intestinal Volvulus / therapy
  • Intestinal Volvulus / veterinary
  • Lactates / blood
  • Male
  • Prognosis
  • Prospective Studies

Grant Funding

  • K01 OD019911 / NIH HHS

Conflict of Interest Statement

CONFLICT OF INTEREST. The authors declare no conflicts of interest related to this report.

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Citations

This article has been cited 1 times.
  1. Smanik LE, Moser DK, Rothers KP, Hackett ES. Serial venous lactate measurement following gastrointestinal surgery in horses. J Vet Sci 2022 Sep;23(5):e66.
    doi: 10.4142/jvs.22038pubmed: 36038187google scholar: lookup
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