Abstract: To determine serum amyloid A (SAA) concentrations in the postoperative (PO) colic horse and its association with PO complications and infection. Methods: Prospective case series. Methods: Fifty-one horses after colic surgery. Methods: Blood samples from horses undergoing exploratory celiotomy were analyzed for quantitative SAA and fibrinogen concentrations and for neutrophil count at days 0, 1, 2, and 4-6 and at hospital discharge. Results: Complications developed in 35 (69%) horses and included PO colic (n = 13, 25%), PO reflux (n = 11, 22%), intravenous catheter (IVC) complications (n = 11, 22%), low-grade fever (n = 11, 22%); surgical site infection (SSI; n = 9, 18%), high-grade fever (n = 7, 14%), and diarrhea (n = 4, 8%). There was an association between day 2 SAA and PO colic (P = .004), diarrhea (P = .042), IVC complications (P = .008), and PO reflux (P = .008) as well as day 4-6 SAA and PO colic (P = .004) and diarrhea (P = .018). Discharge SAA concentration was associated with SSI (P = .001). Fibrinogen concentrations at days 4-6 and at discharge were associated with PO colic (P = .003), diarrhea (P = .004), IVC complications (P = .002), and PO reflux (P = .023). No differences were seen in SAA, fibrinogen, or neutrophils between horses with PO infection vs those with non-infection-associated complications. Conclusions: Serum amyloid A was markedly increased in the PO period in all horses but did not differ between PO infection and noninfection complications. The amount of inflammation associated with PO colic and colic surgery was high and may have affected the predictive value of SAA for early PO infection. Conclusions: Although increases occurred earlier, measurement of SAA with a point-of-care analyzer may not be a more sensitive indicator of infection in the early PO colic horse than fibrinogen concentration. Serum amyloid A may help detect SSI in the late PO period.
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This research aimed to assess the serum amyloid A (SAA) levels in horses after colic surgery and investigate its correlation with postoperative complications and infections.
Study Design and Methodology
The study involved a prospective case series design where 51 horses were observed post colic surgery.
Blood samples were collected and analyzed for SAA levels, fibrinogen concentrations, and neutrophil count at different intervals: days 0, 1, 2, and 4-6, and at the time of hospital discharge.
Results of the Study
Postoperative complications were witnessed in 69% of the horses which included postoperative colic, reflux, intravenous catheter complications, low and high-grade fever, diarrhea, and surgical site infection.
There was a significant association noticed between SAA levels on day 2 and postoperative colic, diarrhea, intravenous catheter complications, and reflux. Similar associations were observed with SAA levels on day 4-6.
In case of SAA concentration at the time of discharge, a significant association was discovered with surgical site infection.
Fibrinogen levels at days 4-6 and at discharge were found to be significantly linked with post-operative colic, diarrhea, intravenous catheter complications, and reflux.
No significant differences were noticed in SAA, fibrinogen, or neutrophils between horses with postoperative infection versus those with non-infection-associated complications.
Conclusion drawn from the Study
All horses showed elevated levels of SAA in the postoperative period regardless of whether they had postoperative infection or noninfection complications, indicating a high degree of inflammation associated with colic and colic surgery.
However, it was observed that the predictive value of SAA for early postoperative infection could be affected due to this high amount of inflammation.
Despite SAA levels increasing sooner, it may not be a more reliable early infection indicator in postoperative colic horses than fibrinogen concentration.
SAA may be utilized to help detect surgical site infection in the late postoperative period.
Cite This Article
APA
Aitken MR, Stefanovski D, Southwood LL.
(2018).
Serum amyloid A concentration in postoperative colic horses and its association with postoperative complications.
Vet Surg, 48(2), 143-151.
https://doi.org/10.1111/vsu.13133
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