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Plasma lactate as a predictor of colonic viability and survival after 360 degrees volvulus of the ascending colon in horses |
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| Authors: | Johnston Kimberly Holcombe Susan J Hauptman Joe G |
| Institution: | Departments of Large Animal Clinical Sciences and Small Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, East Lansing, MI |
| Abstract: | Objectives— To determine the relationship between plasma lactate concentration and colonic viability and survival in horses with ≥360° volvulus of the ascending colon. Study Design— Retrospective study. Animals— Horses (n=73) with ≥360° volvulus of the ascending colon. Methods— Medical records (January 2000–November 2005) of all horses examined for colic at Michigan State University Veterinary Teaching Hospital were reviewed. Horses were included only if plasma lactate concentration was measured preoperatively and a diagnosis of ≥360° volvulus of the ascending colon was confirmed by surgery or necropsy. Non-survivors were only included if the ascending colon was evaluated histopathologically. Logistic regression analysis was used to model the relationship between lactate, colonic viability, and survival. Results— Of 73 horses, 61 were discharged. Mean (±SD) plasma lactate concentration was significantly lower in survivors (2.98±2.53 mmol/L) compared with non-survivors (9.48±5.22 mmol/L; odds ratio OR]=1.628, 95% confidence limit CI]=1.259–2.105). Plasma lactate concentration was significantly lower in horses with a viable colon (3.30±2.85 mmol/L) compared with horses with a non-viable colon (9.1±6.09 mmol/L; OR=1.472, 95% CI=1.173–1.846). Plasma lactate concentration <6.0 mmol/L had a sensitivity of 84% and a specificity 83% for predicting horse survival. Conclusions— Our results demonstrate a strong association between plasma lactate concentration at the time of hospital admission and outcome in horses with ≥360° volvulus of the ascending colon. Clinical Relevance— Plasma lactate concentration may help predict colonic viability and horse survival after ascending colon volvulus in horses. |
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