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1.
REASONS FOR PERFORMING STUDY: There is an absence of data describing the nutritional requirements and nutritional status of horses following surgery for colic; furthermore, the potential effect of parenteral nutrition (PN) on improving nutritional status in such cases is unknown. HYPOTHESIS: Post operative colic cases suffer from a potentially detrimental negative energy balance and the PN formulation developed in this study would lead to clinicopathologically detectable improvements in the subjects' nutritional status. METHODS: Several clinicopathological variables, some known to be associated with nutritional status, were compared in 2 groups of horses in the post operative period following colic surgery; Group N (n = 15) were treated with PN and Group C (n = 15) were starved routinely. RESULTS: Group N had significantly lower serum concentrations of triglycerides, total bilirubin, albumin and urea and significantly higher serum concentrations of glucose and insulin compared with Group C in the post operative period. CONCLUSIONS: The control group of horses demonstrated significant clinicopathological evidence of starvation and the described PN protocol resulted in a demonstrably improved nutritional status in the treated horses. POTENTIAL RELEVANCE: Further study is required to investigate clinical benefits and possible harmful side effects of post operative parenteral nutrition before the technique can be advocated for widespread use in practice.  相似文献   

2.
The case records of 119 young horses (all less than age one year) that underwent an exploratory celiotomy during a 17 year period were examined to determine the surgical findings, short- and long-term outcome, and prevalence of small intestinal disease compared to previous reports in the mature horse. Physical and laboratory values were compared for long-term survivors vs. nonsurvivors and the frequency of post operative intra-abdominal adhesions was determined. The most common cause for exploratory celiotomy was small intestinal strangulation, followed by enteritis and uroperitoneum. Six horses died during surgery, 23 were subjected to euthanasia at the time of surgery due to a grave prognosis, and 17 horses died or were destroyed after surgery, prior to discharge from the hospital; the short-term survival was 61%. Nine horses were lost to follow-up. Forty-one horses survived long-term (at least 6 months after surgery), 15 died or were subjected to euthanasia after discharge for reasons related to the prior abdominal surgery, and 8 died or were destroyed after discharge due to unrelated reasons, making the long-term survival 45%. Fifty-three (45%) of the horses presented as neonates, and 66 (55%) presented age 3-12 months. Uroperitoneum and meconium impaction were the most common disease in the neonate. Intussusception and enteritis were the most common diseases in older foals. The overall prevalence of small intestinal disease was 44%. Significant elevations in packed cell volume, heart rate, nucleated cell counts and total protein in abdominal fluid and rectal temperature were observed in nonsurvivors compared to survivors. Nonsurvivors had significantly decreased serum bicarbonate, chloride, sodium, and venous pH values. There was no evidence that location of the lesion affected long-term survival. Horses with a simple obstruction had a higher survival percentage than those with a strangulating obstruction, and horses that underwent an intestinal resection had a lower long-term survival than those horses undergoing only intestinal manipulation. Nineteen (33%) of the foals examined after the original surgery had evidence of intra-abdominal adhesions. Nine of these (16%) had adhesions that caused a clinical problem.  相似文献   

3.
Reasons for performing the study: In man, peritoneal transforming growth factor beta (TGF‐β) is associated with peritoneal diseases and subsequent adhesion formation. No studies on plasma and peritoneal TGF‐β concentrations in horses with colic are available. Objectives: 1) To determine both plasma and peritoneal TGF‐β1 and TGF‐β3 concentrations in horses with different types of colic (not previously subjected to abdominal surgery); 2) to compare these concentrations according to the type of peritoneal fluid (transudate, modified transudate and exudate); and 3) to compare and correlate plasma and peritoneal concentrations of TGF‐β1 and TGF‐β3 and the types of peritoneal fluid according to the colic group and outcome. Methods: Peritoneal fluid and plasma samples from 78 horses with colic and 8 healthy horses were obtained. Patients were classified according to diagnosis (obstructions, enteritis, ischaemic disorders and peritonitis), peritoneal fluid analysis (transudate, modified transudate and exudate), and outcome (survivors and nonsurvivors). Plasma and peritoneal TGF‐β1 and TGF‐β3 concentrations were determined by ELISA. Data were analysed by parametric and nonparametric tests. P≤0.05 was considered as statistically significant. Results: Concentrations of peritoneal fluid TGF‐β1 were significantly (P = 0.01) higher in horses with peritonitis in comparison with all other colic groups and controls. Horses with ischaemic lesions had significantly (P = 0.01) higher concentrations of peritoneal TGF‐β1 in comparison with controls and the group of horses with obstructions. Peritoneal TGF‐β1 concentration also was significantly (P = 0.01) higher in exudates in comparison with transudates. Peritoneal TGF‐β1 and TGF‐β3 concentrations and plasma TGF‐β1 concentration were significantly increased in nonsurvivors compared to survivors (P = 0.001, P = 0.004 and P = 0.05, respectively). Conclusions: Peritoneal TGF‐β1 concentration was higher in horses with severe gastrointestinal diseases (ischaemic intestinal lesions and peritonitis), in horses with an altered peritoneal fluid (exudate), and in nonsurvivors. Potential relevance: Peritoneal TGF‐β concentration increases in horses with severe gastrointestinal disease as an anti‐inflammatory response.  相似文献   

4.
Point-of-care (POC) systems for the joint measurement of Troponin and D-dimers have not been studied in horses. The aim of this study was to perform the validation of a POC system (AQT90 FLEX) for the measurement of cardiac troponin I (cTnI) and D-dimers in the serum of horses with gastrointestinal diseases. The main objective was to evaluate whether or not this system can distinguish healthy animals from diseased animals. A sample of 33 horses was included in the study: control group (n = 10) and horses with gastrointestinal disorders (n = 21), which were classified according to their outcome in survivors (subgroup A = 9) and nonsurvivors (subgroup B = 12). Considering the diagnosis of the process, ill horses were classified into three groups: inflammatory (I = 7), obstructive (O = 9), and strangulating diseases (S = 5). The clinical usefulness of AQT90 FLEX was validated by the study of linearity, coefficient of variation, and detection limits. Later, concentrations of D-dimers and cTnI were measured. A significant increase in both parameters was detected in ill animals (cTnI: control: 0.014 ± 0.01 μg/mL, survivors: 0.27 ± 0.37 μg/mL, nonsurvivors: 0.60 ± 1.21 μg/mL; D-dimers: control: 104.90 ± 30.82 ng/mL, survivors: 1,217.22 ± 1,213.28 ng/mL, nonsurvivors: 1,613.67 ± 1,426.75 ng/mL), although there were no statistically significant differences in concentrations according to diagnosis and outcome. In conclusion, AQT90 FLEX POC analyzer can be used in horses with gastrointestinal diseases to measure cTnI and D-dimer concentrations. It is a quick, practical, and minimally invasive tool that helps in determining the severity of illness.  相似文献   

5.
OBJECTIVE: To determine concentrations of 2 acute-phase proteins (serum amyloid A [SAA] and lipopolysaccharide-binding protein [LBP]) in serum samples obtained from horses with colic and identify relationships among these acute-phase proteins and clinical data. ANIMALS: 765 horses with naturally developing gastrointestinal tract diseases characterized by colic (ie, clinical signs indicative of abdominal pain) and 79 healthy control horses; all horses were examined at 2 university teaching hospitals. PROCEDURE: Serum concentrations of SAA and LBP were determined by immunoturbidometric and dot-blot assays, respectively. RESULTS: SAA and LBP concentrations were determined for 718 and 765 horses with colic, respectively. Concentrations of SAA were significantly higher in nonsurvivors than in survivors, and horses with enteritis or colitis and conditions characterized by chronic inflammation (eg, abdominal abscesses, peritonitis, or rectal tears) had SAA concentrations significantly greater than those for horses with other conditions. Serum concentrations of LBP did not correlate with outcome, disease process, or portion of the gastrointestinal tract affected. CONCLUSIONS AND CLINICAL RELEVANCE: Circulating concentrations of SAA were significantly higher at admission in horses with colic attributable to conditions having a primary inflammatory cause (eg, enteritis, colitis, peritonitis, or abdominal abscesses) and were higher in horses that failed to survive the episode of colic, compared with concentrations in horses that survived. Serum concentrations of LBP did not correlate with survival. Analysis of these findings suggests that evaluation of SAA concentrations may be of use in identifying horses with colic attributable to diseases that have inflammation as a primary component of pathogenesis.  相似文献   

6.
Protein C content and plasminogen activity were measured in plasma from 100 horses with signs of colic. Data were analyzed by grouping horses 4 ways. Each horse was allotted to 1 of 2 outcome groups (survivors and nonsurvivors), 1 of 3 broad-category diagnosis groups (inflammatory disorders, strangulating obstructions, and all other gastrointestinal disorders), and 1 of 2 clinical management groups (medical and surgical). In a fourth grouping, all horses (although numbers of horses included in each subgroup were small) were assigned either to specific diagnostic groups that had high expectation for activated hemostasis (intestinal ischemia, endotoxemia, jugular thrombosis, peritoneal adhesions, and laminitis) or to a control group, in which active hemostasis was unlikely. Within 2 to 24 hours after admission, nonsurvivors developed lower protein C content than did survivors. Protein C content and plasminogen activity became low during hospitalization in horses with strangulating obstructions and in horses having surgery. The results from the grouping by specific diagnosis must be considered pilot data because the numbers of horses in each subgroup were small. Although not statistically significant, trends were noticed in protein C and plasminogen: (1) horses with intestinal ischemia and endotoxemia developed low protein C content and plasminogen activity, (2) protein C content became low in horses that developed peritoneal adhesions or laminitis, and (3) plasminogen activity became low in horses that developed jugular thrombosis. Low protein C content or low plasminogen activity, or both, may be useful as predictors for outcome and for these specific complications of equine colic.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

7.
Colonic luminal pressure (median, range) measured during ventral midline celiotomy in 69 horses with strangulating obstruction (SO) of the large colon (SO; ≥ 270° large colon volvulus; 27 cm H2O: 2 to 80 cm H2O) was greater ( P =.0023) than that measured in 37 horses with nonstrangulating obstruction (NSO) of the large colon (NSO; ≤ 180° volvulus or a nonstrangulating displacement; 18 cm H2O; 6 to 46 cm H2O). Sixty-five percent (45 of 69) of horses with SO and all horses with NSO survived. Survival analysis was restricted to 59 horses with large-colon SO that survived to hospital discharge or met the criteria specified for classification as nonsurvivors. Colonic luminal pressure in nonsurvivors (48.5 cm H2O; 34 to 80 cm H2O) was higher ( P =.0001) than that measured in survivors (18 cm H2O; 2 to 50 cm H2O) of SO. From response operating characteristic curves, a luminal pressure of 38 cm H2O optimized the distribution of horses with SO into survivor and nonsurvivor groups. Sensitivity, specificity, and positive and negative predictive values for a colonic luminal pressure greater than 38 cm H2O in predicting nonsurvival were 0.89, 0.91, 0.72 and 0.97, respectively. Measurement of colonic luminal pressure may be useful for predicting survival in horses with colonic volvulus.  相似文献   

8.
Colic can be a life‐threatening condition in horses and there is a need for parameters that can help determine the prognosis and need for surgery. The aim of the study was to investigate whether peritoneal fluid (PF) lactate concentration is useful for this purpose in horses with severe colic presented to a veterinary hospital. During a 16 month period, the peritoneal fluid (PF) lactate concentration was measured in 74 of 760 colic horses admitted to the Utrecht University equine clinic using a portable analyser. When comparing survivors and nonsurvivors, heart rate, PF and blood lactate concentrations and blood glucose concentration were significantly higher in horses that did not survive. No horse with a PF lactate concentration >9.4 mmol/l survived. The presence of a strangulating lesion was also significantly associated with nonsurvival, as was PF colour: no horse with red PF survived in the present series. In horses with yellow PF, the blood glucose concentration was correlated with the presence of a strangulating intestinal lesion. Peritoneal lactate concentrations can be easily and rapidly measured using a portable analyser and may be useful in assessing the prognosis and/or need for surgery in equine colic cases.  相似文献   

9.
Antithrombin III activity in horses with colic: an analysis of 46 cases   总被引：3，自引：0，他引：3  
Antithrombin-III (AT-III) activity was measured at the time of admission in 46 horses referred with colic. Differences in AT-III activities between animals treated medically or surgically and survivors or non-survivors were compared. The mean AT-III values for the horses treated medically (76.2 per cent), surgical survivors (69.5 per cent) and surgical non-survivors (55.9 per cent) were significantly different from the reference value for healthy adults (92 to 108 per cent). The mean AT-III activity of the survivors was significantly (P less than 0.01) greater than that of the nonsurvivors. The majority of the survivors (11 to 13 horses) had AT-III activities exceeding 60 per cent of normal, whereas that of 10 of the 14 non-survivors was less than 60 per cent of normal. There was an apparent distinction between the survivors and non-survivors at approximately 60 per cent of normal AT-III activity.  相似文献   

10.
The records of all dogs and cats receiving total parenteral nutrition (TPN) over a 43-month period were examined retrospectively. Dextrose, amino acids, lipids, electrolytes, and vitamins were administered by central venous catheter according to published nutrient recommendations; 72 dogs and 12 cats were studied, accounting for 380 patient days of TPN. Duration of TPN administration was 1–14 days with a mean of 4.5 days. Most animals required TPN because of gastrointestinal dysfunction, and more than half of them gained weight during TPN administration. Mechanical complications were frequent. Metabolic complications, especially lipid and glucose intolerance, were also commonly seen. Septic complications were the least frequently encountered, but resulted in patient morbidity and may have contributed to mortality. Most animals receiving TPN were returned to enteral nutrition and discharged. For critically ill animals unable to tolerate enteral alimentation, TPN can be supportive therapy in the treatment of the primary disease.  相似文献   

11.
OBJECTIVE: To identify apoptosis in equine intestines and determine whether apoptosis is associated with gastrointestinal tract disease or a specific tissue layer of intestine. ANIMALS: 38 horses that underwent surgery or were euthanatized for small or large intestine obstruction, strangulation, or distension and 9 control horses euthanatized for reasons other than gastrointestinal tract disease or systemic disease. PROCEDURE: Specimens were collected at surgery from intestine involved in the primary lesion and distant to the primary lesion site or at necropsy from several sites including the primary lesion site. Histologic tissue sections were stained with H&E, and apoptosis was detected by use of the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling technique. The number of apoptotic cells per hpf was counted in the mucosa, circular muscle, longitudinal muscle, and serosa. RESULTS: Apoptotic nuclei were seen in all layers of intestine. An increased number of apoptotic cells was found in the circular muscle of the intestine from horses with simple obstruction, compared with strangulating obstruction or healthy intestine. Intestine distant from a primary strangulating lesion had higher numbers of apoptotic cells than did intestine distant from a simple obstructive lesion or intestine taken at the site of a strangulating or simple obstructive lesion. CONCLUSIONS AND CLINICAL RELEVANCE: Intestine from horses with obstructing or strangulating lesions in the small intestine and large colon had high numbers of apoptotic cells possibly because of ischemic cell injury and subsequent inflammation. Whether substantial apoptosis affects intestinal function is not yet known.  相似文献   

12.
In order to determine which variables are useful and accurate in estimating prognosis in horses with abdominal pain, data were analyzed from 231 horses presented at a veterinary teaching hospital. Using multiple stepwise discriminant analysis in a recursive partition model, we obtained a decision protocol that identified survivors and nonsurvivors. The prevalence of survivors was 61% in this population. The sensitivity, specificity, and positive and negative predictive values of this model were 71, 83, 87 and 65%, respectively. This decision protocol was validated by Jackknife classification and also by evaluation with a referral population of 100 horses in which the prevalence of survivors was 83%. This led to sensitivity, specificity, and positive and negative predictive values of 83, 78, 94 and 50%, respectively.  相似文献   

13.
Background: Sequential lactate concentration ([LAC]) measurements have prognostic value in that hospitalized humans and neonatal foals that have a delayed return to normolactatemia have greater morbidity and case fatality rate.
Hypothesis: Prognosis for survival is decreased in horses with a delayed return to normal [LAC].
Animals: Two hundred and fifty adult horses presented for emergency evaluation excepting horses evaluated because of only ophthalmologic conditions, superficial wounds, and septic synovitis without systemic involvement.
Methods: Prospective observational study. [LAC] was measured at admission and then at 6, 12, 24, 48, and 72 hours after admission. The change in [LAC] over time ([LAC]Δ T ) was calculated from changes in [LAC] between sampling points.
Results: Median [LAC] was significantly ( P < .001) higher at admission in nonsurvivors (4.10 mmol/L [range, 0.60–18.20 mmol/L]) when compared with survivors (1.30 mmol/L [range, 0.30–13.90 mmol/L]) and this difference remained at all subsequent time points. The odds ratio for nonsurvival increased from 1.29 (95% confidence interval 1.17–1.43) at admission to 49.90 (6.47–384) at 72 hours after admission for every 1 mmol/L increase in [LAC]. [LAC]Δ T was initially positive in all horses but became negative and significantly lower in nonsurvivors for the time periods between 24–72 hours (− 0.47, P = .001) and 48–72 hours (− 0.07, P = .032) when compared with survivors (0.00 at both time periods) consistent with lactate accumulation in nonsurvivors.
Conclusions and Clinical Importance: These results indicate that lactate metabolism is impaired in critically ill horses and [LAC]Δ T can be a useful prognostic indicator in horses.  相似文献   

14.
The present study was carried out to assess the prognostic significance of oxidative stress markers in draft horses with colitis associated with phenylbutazone administration under field condition. For this purpose, a total of 40 native breed draft horses were studied. Based on case history, physical examination, and postmortem findings, diagnosis was made. According to the clinical outcome, horses were categorized into survivors and nonsurvivors. Clinically, there was significant association between nonsurvivors and anorexia (P < .01), stasis of intestinal motility (P < .01), melena (P < .01), and diarrhea (P < .001). Biochemically, malondialdehyde and nitric oxide showed a significant increase (P < .05) in nonsurvivors compared with survivors, whereas activities of superoxide dismutase showed a significant decrease (P < .05). Analysis of receiver operating characteristic curve indicated a high sensitivity and specificity of malondialdehyde, nitric oxide, and superoxide dismutase levels (P < .001) to predict the clinical outcome of colitis. Additionally, total protein and albumin showed a significant decrease in nonsurvivors compared with survivors; however, aspartate aminotransferase, sorbitol dehydrogenase, urea, and creatinine showed an increase (P < .05). The present results suggest that estimation of oxidative stress markers and antioxidant parameters may be useful predictors of the clinical outcomes of colitis associated with phenylbutazone administration in draft horses.  相似文献   

15.
Over a 24-month period, serum tumor necrosis factor (TNF) activity was determined in 289 horses with colic attributable to gastrointestinal tract disease. Serum TNF activity was quantitated by use of a modified in vitro cytotoxicity bioassay, using WEHI 164 clone-13 murine fibrosarcoma cells. Causes for colic, determined by clinical and laboratory evaluation, exploratory celiotomy, or necropsy included: gastrointestinal tract rupture (GTR); ileal impaction; small intestinal strangulating obstruction (SIO); proximal enteritis (PE); transient small intestinal distention; large-colon displacement; large-colon volvulus; large-colon impaction; colitis; small-colon obstruction; peritonitis; and unknown. Each diagnosis was placed into 1 of 3 lesion categories: inflammatory disorders (GTR, PE, colitis, peritonitis); strangulating intestinal obstruction (SIO, large-colon volvulus); and nonstrangulating intestinal obstruction (ileal impaction, transient small intestinal distension, large-colon displacement, large-colon impaction, small-colon obstruction, unknown). The prevalence of high serum TNF activity and/or mortality were evaluated. Differences were tested at significance level of P less than 0.05. Approximately 20% of the 289 horses has serum TNF activity greater than that found in clinically normal horses (greater than 2.5 U/ml). Twenty-three horses (8%) had marked increase in serum TNF activity (greater than or equal to 10 U/ml) which was more prevalent among horses with SIO and PE than in horses of other diagnostic groups, except those with GTR. Mortality and marked increase in serum TNF activity were greater in horses with intestinal inflammatory disorders or strangulating intestinal obstruction than in horses with nonstrangulating intestinal obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

16.
Background: Coagulopathies detected in horses with gastrointestinal problems seem to be associated with poor outcome. Plasma D‐Dimer concentration is a sensitive test for assessing coagulopathies. Hypothesis: Plasma D‐Dimer concentration tested on admission is related to diagnosis and outcome in horses with colic. Animals: Four hundred and ninety three horses referred for evaluation of abdominal pain. Methods: Prospective observational clinical study. Horses were grouped according to diagnosis (medical and surgical intestinal obstructions, ischemic disorders with and without intestinal resection, enteritis, peritonitis), outcome (survivors, nonsurvivors), and number of coagulopathies (normal profile, 1 or 2 coagulopathies, subclinical disseminated intravascular coagulation [DIC]). Blood samples were collected on admission and plasma D‐Dimer concentration, clotting times (PT and aPTT), and antithrombin activity were determined. Positive likelihood ratios (LR+) were calculated for evaluation of D‐Dimer cut‐off values, which were later tested in a logistic regression model. Results: Horses with enteritis or peritonitis had significantly (P < .001) higher plasma D‐Dimer concentrations and more severe coagulopathies on admission than horses with other diagnoses. Nonsurvivors also had significantly (P < .001) higher plasma D‐Dimer concentrations at presentation than did survivors, and those horses with subclinical DIC on presentation had an odds ratio (OR) 8.6 (95% confidence interval [CI], 3.3–22.5, P < .001) for nonsurvival. Finally, D‐Dimer concentrations >4,000 ng/mL had a LR+ of 5.9 and an OR 8.8 (95% CI, 4.5–17.1, P < .001) for nonsurvival. Conclusion and Clinical Importance: Plasma D‐Dimer concentration measured on admission can be used to facilitate diagnosis and outcome prediction in horses with colic. A potential cut‐off value for nonsurvival was found at approximately 4,000 ng/mL.  相似文献   

17.
Strangulating volvulus of the ascending colon in horses   总被引：2，自引：0，他引：2  
Of 57 horses with strangulating volvulus of the ascending colon, 42 were mares (including 21 postparturient mares), 8 were stallions, and 7 were geldings. Volvulus occurred most frequently in the summer (n = 24) and spring (n = 17). Pain was evaluated as severe in 41 horses, moderate in 9, and mild in 4. The abdominal fluid from 30 horses varied from clear yellow in 19 horses, to cloudy yellow in 3 horses, and serosanguineous in 8 horses. Protein content and nucleated cell count in the abdominal fluid were 2.5 +/- 1 g/dl and 1,000 +/- 900 microliters, respectively. Fifty horses had greater than or equal to 360 degrees volvulus and 7 had a 270 degrees volvulus, with 49 occurring in a counterclockwise direction. The site of volvulus in all horses was at the mesenteric attachment of the colon, except for a 360 degrees volvulus at the sternal and diaphragmatic flexures in 1 horse. Survival rates for horses with a greater than or equal to 360 degrees and a 270 degrees volvulus were 36% and 71%, respectively. The difference in survival rates reflected the severe vascular occlusion in the colon of horses with greater than or equal to 360 degrees volvulus. In nonsurvivors, hemorrhage in the submucosa and lamina propria (P less than 0.005) and edema in the submucosa (P less than 0.01) were greater than those in survivors. In nonsurvivors, greater than 97% of the superficial epithelium was lost. In horses that survived, only 60% of the cells were lost or degenerated.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

18.
This retrospective case series describes clinicopathological data and outcome of hospitalised atypical myopathy (AM) cases in the South-East of England. The study aimed to describe the frequency of metabolic abnormalities (hyperglycaemia, hyperlactataemia, hypertriglyceridaemia) and outcome in AM cases in the South-East of England and test the hypothesis that serum creatine kinase (CK) activity and blood glucose, lactate and triglyceride concentrations are associated with outcome. Medical records (2011–2017) from three referral hospitals were reviewed for cases with a clinical diagnosis of AM. A previously described algorithm was applied and cases were included if a diagnosis of AM was considered highly likely. In cases admitted after 2013 known or possible exposure to sycamore trees was also required for inclusion. Sixty-four animals were included, 44% (28/64) survived. Hyperglycaemia, hyperlactataemia and hypertriglyceridaemia were present in 76%, 89% and 92% of horses on admission, respectively. Survivors had lower blood lactate concentrations (survivors: median 3.5 mmol/L; range 0.5–10.4 mmol/L vs. nonsurvivors: median 7.3 mmol/L; range 2.5–16.5 mmol/L; P = 0.011) and serum CK activities (survivors: median 38,369 U/L; range 7024–570,498 U/L vs. nonsurvivors: median 172,687 U/L; range 2036–570,953 U/L; P = 0.027) on admission when compared to nonsurvivors. Increasing CK activity (P = 0.008) and triglyceride concentrations (P = 0.038) during hospitalisation were associated with nonsurvival. More nonsurvivors required sedation (18/29; 62.1% vs. 4/22; 18.2%; P = 0.002). The prognosis for hospitalised horses with AM is guarded and outcome in this population was associated with admission CK activity and lactate concentrations, and increasing CK activity and triglyceride concentrations and need for sedation during hospitalisation.  相似文献   

19.
Background: Fibrin(ogen) degradation products (FDPs) and D‐dimer are sensitive indicators of excessive fibrinolysis due to disseminated intravascular coagulation (DIC) in dogs. To the authors' knowledge, latex‐agglutination–based plasma FDP and D‐dimer assays have not been validated for use in horses. Objectives: To determine: 1) sensitivity and specificity of latex‐agglutination serum and plasma FDP and D‐dimer assays for diagnosis of DIC; and 2) their prognostic value in horses with severe colic. Methods: At hospital admission and 24 hours later, blood was collected from 30 healthy horses and 20 horses with severe colic. Horses fulfilling predefined laboratory criteria of DIC were enrolled, and their data were subcategorized by survival for analysis. Platelet counts were determined and coagulation panel testing was performed. Serum and plasma FDP concentrations were measured using separate latex agglutination kits. Plasma D‐dimer concentration was measured using 3 latex agglutination kits and a card immunofiltration test. Test sensitivity and specificity results were determined for healthy horses and those with colic. Median test values were compared between colic survivors and nonsurvivors to evaluate the prognostic usefulness of all tests. Results: Performance characteristics varied among assays and kit suppliers. The FDP assays had low sensitivity (<40%), whereas the most accurate D‐dimer kit had 50% sensitivity and 97% specificity. High D‐dimer concentration was the third most common hemostatic abnormality in horses with colic. Median antithrombin (AT) activity was significantly lower and activated partial thromboplastin time (aPTT) was significantly longer in nonsurvivors than survivors. Conclusions: Commercial latex‐agglutination D‐dimer assays might prove useful as adjunctive tests for the diagnosis of DIC in horses with severe colic; however FDP assays are invalid for this purpose. Low AT activity and prolonged aPTT at admission are associated with a poor prognosis in this patient population.  相似文献   

20.
Background: Plasma d -dimer concentration is a useful marker to assess systemic coagulation and fibrinolytic activities in humans, dogs, and horses. Peritoneal fibrinolytic activity increases in horses with colic, especially in horses with endotoxin in the peritoneal fluid.
Hypothesis/Objectives: Peritoneal d -dimer concentration can be used to assess peritoneal fibrinolytic activity in horses with severe gastrointestinal (GI) disorders and altered peritoneal fluid.
Animals: Two hundred and twenty-one colic horses and 15 control horses.
Methods: Prospective observational clinical study. Blood and peritoneal fluid were collected on admission. Horses were grouped according to diagnosis, peritoneal fluid analysis, and outcome. Peritoneal d -dimer concentration was determined, together with peritoneal tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) activities. Plasma d -dimer concentration also was measured.
Results: Peritoneal d -dimer concentration was significantly higher in all colic groups compared with controls, and in horses with enteritis, peritonitis, and ischemic disorders compared with horses with large intestinal obstructions. Peritoneal d -dimer concentration was significantly higher in horses with altered peritoneal fluid (modified transudate and exudate) compared with horses with normal peritoneal fluid analysis. Plasma d -dimer concentration also was significantly higher in the peritonitis group, and in horses with altered peritoneal fluid analysis. Peritoneal and plasma d -dimer concentrations also were significantly higher in nonsurvivors. Peritoneal d -dimer concentration was significantly correlated with decreased peritoneal t-PA activity and increased peritoneal PAI-1 activity.
Conclusions and Clinical Importance: Peritoneal d -dimer concentration is markedly higher in severe GI disorders, and it can be used to assess peritoneal fibrinolytic activity in horses with colic.  相似文献   

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