FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Vet Surg / Prognostic value of colonic and peripheral venous lactate me...
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.
Get Full Text
Publication Date: 2020-01-09 PubMed ID: 31916608PubMed Central: PMC8984623DOI: 10.1111/vsu.13361Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

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.

References

This article includes 35 references
  1. Driscoll N, Baia P, Fischer AT, Klohnen A. Large colon resection and anastomosis in horses: 52 cases (1996–2006).. Equine Vet J 2008;40:342–347.
    pubmed: 18321811
  2. Ellis CM, Lynch TM, Slone DE, Hughes FE, Clark CK. Survival and complications after large colon resection and end-to-end anastomosis for strangulating large colon volvulus in seventy-three horses.. Vet Surg 2008;37:786–790.
    pubmed: 19121175
  3. Hughes FE, Slone DE Jr. Large colon resection.. Vet Clin North Am Equine Pract 1997;13:341–350.
    pubmed: 9290187
  4. Levi O, Affolter VK, Benak J, Kass PH, Le Jeune SS. Use of pelvic flexure biopsy scores to predict short-term survival after large colon volvulus.. Vet Surg 2012;41:582–588.
    pubmed: 22571759
  5. Kelleher ME, Brosnan RJ, Kass PH, le Jeune SS. Use of physiologic and arterial blood gas variables to predict short-term survival in horses with large colon volvulus.. Vet Surg 2013;42:107–113.
    pubmed: 23216048
  6. Johnston K, Holcombe SJ, Hauptman JG. Plasma lactate as a predictor of colonic viability and survival after 360 degrees volvulus of the ascending colon in horses.. Vet Surg 2007;36:563–567.
    pubmed: 17686130
  7. Suthers JM, Pinchbeck GL, Proudman CJ, Archer DC. Survival of horses following strangulating large colon volvulus.. Equine Vet J 2013;45:219–223.
    pubmed: 22994687
  8. Van Hoogmoed L, Snyder JR, Pascoe JR, Olander H. Use of pelvic flexure biopsies to predict survival after large colon torsion in horses.. Vet Surg 2000;29:572–577.
    pubmed: 11098791
  9. Embertson RM, Cook G, Hance SR, Bramlage LR, Levine J, Smith S. Large colon volvulus: surgical treatment of 204 horses (1986–1995).. Proc Am Assoc Equine Pract 1996;42:254–255.
  10. Hackett ES, Embertson RM, Hopper SA, Woodie JB, Ruggles AJ. Duration of disease influences survival to discharge of Thoroughbred mares with surgically treated large colon volvulus.. Equine Vet J 2015;47:650–654.
    pubmed: 25257041
  11. Brusie RW, Sullins KE, Silverman DG, Rosenberger JL. Fluorometric evaluation of large and small intestinal ischaemia in the horse.. Equine Vet J 1989;21:358–363.
    pubmed: 2776723
  12. Sullins KE, Stashak TS, Mero K, McChesney A. Intravenous fluorescein dye as an indicator of small and large intestinal viability in the horse.. Proc Equine Colic Res Symp 1986;2:280–288.
  13. Snyder JR, Pascoe JR, Meagher DM, Thurmond MC. Surface oximetry for intraoperative assessment of colonic viability in horses.. J Am Vet Med Assoc 1994;204:1786–1789.
    pubmed: 8063601
  14. Moore RM, Hance SR, Hardy J, Moore BR, Embertson RM, Constable PD. Colonic luminal pressure in horses with strangulating and nonstrangulating obstruction of the large colon.. Vet Surg 1996;25:134–141.
    pubmed: 8928391
  15. Mathis SC, Slone DE, Lynch TM, Hughes FE, Clark CK. Use of colonic luminal pressure to predict outcome after surgical treatment of strangulating large colon volvulus in horses.. Vet Surg 2006;35:356–360.
    pubmed: 16756616
  16. Hurcombe SD, Welch BR, Williams JM, Cooper ES, Russell D, Mudge MC. Dark-field microscopy in the assessment of large colon microperfusion and mucosal injury in naturally occurring surgical disease of the equine large colon.. Equine Vet J 2014;46:674–680.
    pubmed: 24164428
  17. Gonzalez LM, Fogle CA, Baker WT. Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013.. Equine Vet J 2015;47: 279–284.
    pmc: PMC4198525pubmed: 24735170
  18. Southwood LL. Postoperative management of the large colon volvulus patient.. Vet Clin North Am Equine Pract 2004;20: 167–197.
    pubmed: 15062464
  19. Fiege JK, Hackett ES, Rao S, Gillette SC, Southwood LL. Current treatment of ascending colon volvulus in horses: a survey of ACVS diplomates.. Vet Surg 2015;44:398–401.
    pubmed: 24724874
  20. Moore JN, Owen RR, Lumsden JH. Clinical evaluation of blood lactate levels in equine colic.. Equine Vet J 1976;8:49–54.
    pubmed: 4300
  21. Dallap BL, Dolente B, Boston R. Coagulation profiles in 27 horses with large colon volvulus.. J Vet Emerg Crit Care 2003;13:215–225.
  22. Latson KM, Nieto JE, Beldomenico PM, Snyder JR. Evaluation of peritoneal fluid lactate as a marker of intestinal ischaemia in equine colic.. Equine Vet J 2005;37:342–346.
    pubmed: 16028624
  23. Yamout SZ, Nieto JE, Beldomenico PM, Dechant JE, leJeune S, Snyder JR. Peritoneal and plasma d-lactate concentrations in horses with colic.. Vet Surg 2011;40:817–824.
    pubmed: 21815898
  24. Kilcoyne I, Nieto JE, Dechant JE. Predictive value of plasma and peritoneal creatine kinase in horses with strangulating intestinal lesions.. Vet Surg 2019;48:152–158.
    pubmed: 30588637
  25. De Backer D. Lactic acidosis.. Intensive Care Med 2003;29:699–702.
    pubmed: 12682722
  26. Kawcak CE, Baxter GM, Getzy DM, Stashak TS, Chapman PL. Abnormalities in oxygenation, coagulation, and fibrinolysis in colonic blood of horses with experimentally-induced strangulation obstruction.. Am J Vet Res 1995;56:1642–1650.
    pubmed: 8599527
  27. Hughes FE, Slone DE. A modified technique for extensive large colon resection and anastomosis in horses.. Vet Surg 1998;27:127–131.
    pubmed: 9525027
  28. Snyder JR, Olander HJ, Pascoe JR, Holland M, Kurpershoek CJ. Morphologic alterations observed during experimental ischemia of the equine large colon.. Am J Vet Res 1988;49:801–809.
    pubmed: 3400917
  29. Hajian-Tilaki K. Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation.. Caspian J Intern Med 2013;4:627–635.
    pmc: PMC3755824pubmed: 24009950
  30. Roy MF, Kwong GPS, Lambert J, Massie S, Lockhart S. Prognostic value and development of a scoring system in horses with systemic inflammatory response syndrome.. J Vet Intern Med 2017;31:582–592.
    pmc: PMC5354005pubmed: 28207163
  31. Proudman CJ, Edwards GB, Barnes J, French NP. Modelling long-term survival of horses following surgery for large intestinal disease.. Equine Vet J 2005;37:366–370.
    pubmed: 16028630
  32. Peloso JG, Cohen ND. Use of serial measurements of peritoneal fluid lactate concentration to identify strangulating intestinal lesions in referred horses with signs of colic.. J Am Vet Med Assoc 2012;240:1208–1217.
    pubmed: 22559111
  33. Tennent-Brown BS, Wilkins PA, Lindborg S, Russell G, Boston RC. Sequential plasma lactate concentrations as prognostic indicators in adult equine emergencies.. J Vet Intern Med 2010;24:198–205.
    pubmed: 19925572
  34. Henderson ISF. Diagnostic and prognostic use of L-lactate measurement in equine practice.. Equine Vet Educ 2013;25:468–475.
  35. McCoy AM, Hackett ES, Wagner AE, Mama KR, Hendrickson DA. Pulmonary gas exchange and plasma lactate in horses with gastrointestinal disease undergoing emergency exploratory laparotomy: a comparison with an elective surgery horse population [erratum: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1532-950X.2011.00954.x].. Vet Surg 2012;41:316.
    doi: 10.1111/j.1532-950X.2011.00954.xpubmed: 21539581google scholar: lookup

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
Subscribe to our newsletter
Join 99,001 horse owners like you who receive our email updates on horse health and nutrition.