Intern University of Guelph Guelph, Ontario, Canada
Abstract:
Background: Early and accurate identification of ischemic strangulating lesions of the small intestine (SISO) and large colon (LCSO) is crucial to reduce complications and increase survival of horses with colic. The predictive value of Peritoneal (PL) and blood (BL) lactate ratio (PL:BL ratio) and PL-BL difference for SISO and LCSO is still unclear.
Objective: Determine whether PL:BL ratio and PL-BL difference values are sensitive indicators of SISO and LCSO in horses with colic. Animals: 58 horses with SISO, 71 non-SISO, 204 non-LCSO, and 38 LCSO.
Methods: Retrospective case-control study. Final diagnosis was retrieved from medical records. Diagnosis of SISO and LCSO was made in surgery or necropsy. Non-SISO diagnoses included: proximal enteritis (n=23), ileal impaction (n=41) and others (n=7). Non-LCSO included nephrosplenic entrapment (n=48), gas colic (n=36), impaction (n=38), colitis (n=27), right dorsal colon displacement (n=27), others (n=28).
Results: A PL:BL ratio of 1.5 had a sensitivity and specificity of 0.67 and 0.65 and 0.71 and 0.76 for detection of SISO and LCSO, respectively. The AUC-ROC for this PL:BL ratio cut-point was 0.66 and 0.73 for SISO and LCSO, respectively. A PL-BL difference of 2.2 mmol/L and 2.6 mmol/L had a sensitivity and specificity of 0.79 and 0.82 and 0.79 and 0.88 for detection of SISO and LCSO, respectively. The AUC-ROC for PL-BL difference was 0.79 and 0.84 for SISO and LCSO, respectively.
Conclusions: PL:BL ratio and PL-BL difference can be used for diagnosis of SISO or LCSO, although PL-BL difference may be a better predictor of strangulating lesions.
