Use of multiple admission variables better predicts intestinal strangulation in horses with colic than peritoneal or the ratio of peritoneal:blood l-lactate concentration.
Abstract: Early identification of strangulating obstruction (SO) in horses with colic improves outcomes, yet early diagnosis of horses requiring surgery for SO often remains challenging. Objectives: To compare blood and peritoneal fluid l-lactate concentrations, peritoneal:blood l-lactate ratio, peritoneal minus blood (peritoneal-blood) l-lactate concentration and other clinical variables for predicting SO and SO in horses with small intestinal lesions (SO-SI) and then to develop a multivariable model to predict SO and SO-SI.
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Publication Date: 2023-08-04 PubMed ID: 37539736DOI: 10.1111/evj.13977Google Scholar: Lookup
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- Journal Article
Summary
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The study focuses on early diagnosis of strangulating obstruction (SO) in horses experiencing colic. Strangulating obstruction is a severe condition where a portion of the intestine gets trapped, cutting off blood flow. Timely diagnosis can significantly improve the horse’s chances of recovery.
Background:
- Early diagnosis of SO is crucial for better outcomes.
- However, diagnosing horses that need surgery due to SO is often difficult.
Objective: The study aims to:
- Compare various metrics, including blood and fluid concentrations of l-lactate and their ratios, as predictors of SO.
- Develop a comprehensive predictive model for SO and particularly for SO in horses with small intestinal lesions (SO-SI).
Study Design: The research was retrospective, meaning it analyzed past cases rather than conducting a new experiment.
Methods:
- The study looked at 197 horses admitted for colic between 2016 and 2019.
- These horses had peritoneal fluid analyses when they were admitted.
- 23 variables from their admission were considered for their predictive value for SO or SO-SI.
- Statistical tools were then used to assess the significance of each variable in predicting the conditions.
Results:
- The predictive variables worked better when combined than when used individually.
- For predicting SO, significant factors included severity of abdominal pain, body temperature, properties of the peritoneal fluid, and certain l-lactate measurements. The model’s accuracy was measured with an AUC ROC of 0.91, which is quite high, indicating good predictive power.
- For predicting SO-SI, factors included volume of reflux, l-lactate concentration in the blood, properties of the peritoneal fluid, and l-lactate concentration in the peritoneal fluid.
Limitations: The study is retrospective and was conducted at a single hospital, so the findings may not be universally applicable.
Conclusions:
- L-lactate concentrations in both blood and peritoneal fluid are valuable, but they should be considered alongside other clinical indicators.
- The relationship between these l-lactate measurements became complicated when used in a combined model.
- Predictive models for SO might differ based on where the lesion is located in the horse’s body.
In simpler terms, the study aimed to find better ways to predict a severe intestinal condition in horses. By looking at past cases and using various measurements, researchers were able to identify several factors that could help in making early and accurate diagnoses. However, these factors are best used in combination and may vary depending on the exact location of the intestinal issue.
Cite This Article
APA
Long AE, Southwood LL, Morris TB, Brandly JE, Stefanovski D.
(2023).
Use of multiple admission variables better predicts intestinal strangulation in horses with colic than peritoneal or the ratio of peritoneal:blood l-lactate concentration.
Equine Vet J.
https://doi.org/10.1111/evj.13977 Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
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Citations
This article has been cited 6 times.- Nocera I, Cingottini D, Di Franco C, Sala G, Bindi F, Spadari A, Rinnovati R, Vitale V, Jose-Cunilleras E, Sgorbini M. In-Depth Analysis of the Prognostic Factors Associated with Short-Term Outcome in Equine Colic Patients: Multicentric Retrospective Study. Animals (Basel) 2026 Feb 5;16(3).
- Meistro F, Rinnovati R, Blanc E, Berni P, Napoli S, Marcucci E, D'Angelo P, Ruggeri M, Spadari A, Gialletti R. Prognostic Significance of Erythrocyte Sedimentation Rate for Survival in Equine Colic. Animals (Basel) 2026 Feb 3;16(3).
- Crosby CE, O'Connor A, Munsterman AS. Alactic base excess is not a sensitive or specific diagnostic tool for outcome in horses with colic. Front Vet Sci 2025;12:1618304.
- Bishop RC, Arrington JV, Wilkins PA, McCoy AM. Alterations in the Peritoneal Fluid Proteome of Horses with Colic Attributed to Ischemic and Non-Ischemic Intestinal Disease. Animals (Basel) 2025 May 30;15(11).
- Parra-Moyano LA, Cedeño A, Darby S, Johnson JP, Gomez DE. Blood and Peritoneal Lactate, Ratio and Difference, and Peritoneal Lactate to Total Solids Ratio for Detection of Intestinal Strangulating Obstructions in Horses. J Vet Intern Med 2025 Jul-Aug;39(4):e70121.
- Milner PI, Bardell D. Can Arterial Blood Gas, Electrolyte and Acid-Base Analysis at Admission be Used to Predict Survival to Hospital Discharge for Different Causes of Colic?. Vet Med Sci 2025 Mar;11(2):e70210.
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