Clinicopathologic Parameters of Peritoneal Fluid as Predictors of Gastrointestinal Lesions, Complications, and Outcomes in Equine Colic Patients: A Retrospective Study


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Article

1

Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27606, USA

2

Department of Veterinary Biosciences, The Ohio State University College of Veterinary Medicine, Columbus, OH 43210, USA

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Department of Pathology, Microbiology, and Immunology, University of California Davis School of Veterinary Medicine, Davis, CA 95616, USA

4

Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA 30602, USA

5

Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA 30602, USA

*

Author to whom correspondence should be addressed.

Submission received: 1 November 2024
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Revised: 11 December 2024
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Accepted: 18 December 2024
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Published: 24 December 2024

(This article belongs to the Section Equids)

Simple Summary

Delays in diagnosis and treatment of equine colic can lead to poor outcomes. The analysis of fluid from the abdominal (or “peritoneal”) cavity is a valuable means for assessing peritoneal and intestinal health. Specific peritoneal fluid biomarkers can be evaluated to rapidly identify gastrointestinal lesions that require surgery. However, some colic cases are not straightforward, and thus additional biomarkers are needed. Neutrophils are white blood cells that respond quickly to infection and tissue damage and can increase in peritoneal fluid during colic. In this study, we retrospectively evaluated neutrophil counts in equine peritoneal fluid of colic horses to understand if they can help us to predict the strangulated nature of a gastrointestinal lesion and potential outcomes. Horses with strangulating gastrointestinal lesions, which occur when blood supply has been lost to the tissues and requires surgery, had higher peritoneal fluid neutrophils than horses that did not have strangulating lesions. Additionally, horses that developed complications and those that did not survive to discharge also had higher peritoneal fluid neutrophil counts. In conclusion, peritoneal fluid neutrophil counts may help to predict gastrointestinal lesion types and outcomes, and the role of neutrophils in these gastrointestinal lesions and complications warrants further study to understand if they might be a target for therapies.

Abstract

Neutrophil characteristics in peritoneal fluid (PF) may aid in diagnosing and treating specific colic lesions and complications. The objective of this retrospective study was to evaluate quantitative PF leukocyte values, as well as PF total protein (TP) and lactate, for associations with diagnosis, morbidity, and mortality in horses with acute colic. Three hundred and forty-two horses that presented to one institution between January 2010–2020 for the evaluation of acute colic were included. The PF total nucleated cell count (TNCC), % and total neutrophil counts, total protein (TP), and lactate were analyzed for associations with lesion location and type, the development of postoperative reflux (POR) or systemic inflammatory response syndrome (SIRS), and survival to discharge via Kruskal–Wallis testing. Horses with strangulating lesions had higher PF % neutrophils, neutrophil count, and TNCC compared to non-strangulating lesions. The development of SIRS or POR was associated with higher PF TNCC, total neutrophil count, TP, and lactate. Horses that did not survive to discharge had increased PF % neutrophils, neutrophil count, TP, lactate, and ratio of PF-to-systemic TP than those that survived via univariable analysis. Identified associations between increased PF neutrophils and the development of POR and SIRS warrant further investigation to better understand their role in the pathogenesis of equine colic and potential as targets for therapeutic intervention.

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Emily Martin www.mdpi.com