Evaluation of peritoneal l-lactate concentration in horses in the early post-partum period

BACKGROUND

Peritoneal fluid lactate concentration is an important diagnostic tool in horses with abdominal pain. Information on peritoneal lactate concentrations is lacking following parturition in the mare.

OBJECTIVES

To compare blood and peritoneal lactate concentrations in a population of mares within 36 h post-partum, report a normal reference range and identify any impact of retained foetal membranes (RFMs).

METHODS

This is a retrospective study evaluating healthy mares from which blood and peritoneal samples had been obtained within 36 h of parturition. Exclusion criteria included signs of abdominal pain within this period. Data was interrogated for normality using a Shapiro-Wilk test. Wilcoxon signed-rank test and Bland-Altman analysis were used to compare blood and peritoneal lactate concentrations. Linear regression was used to compare age and breed data with peritoneal lactate concentrations. Significance was defined as p < 0.05.

RESULTS

Forty mares met the inclusion criteria. Mean age was 12.6 ± 4.1 years, and most mares were multiparous (65%). Peritoneal lactate ((1.2 (IQR = 0.9-1.6) mmol/L) was increased compared to blood lactate concentration (0.7 (IQR = 0-1.1)mmol/L; p < 0.001). Plasma total protein (TP) concentrations were 68 (IQR = 64-74) g/L and peritoneal protein concentrations 8 (IQR = 4-9.7) g/L. Six mares developed RFM. The median fold-increase in peritoneal lactate concentration compared to blood lactate concentration was 0.9 (IQR: 0.01-1.7; range: 0-2.5). The reference range for peritoneal fluid lactate concentration was 0-2.5 mmol/L.

CONCLUSION

Peritoneal lactate concentrations in healthy post-partum mares remained within the normal reference range and were not influenced by RFM or parturition. Increased peritoneal lactate in this group warrants further investigation.

Comparison of plasma l-lactate between jugular and cephalic veins in healthy and systemically ill horses using a point-of-care device

OBJECTIVE

To compare plasma l-lactate (LAC) values between samples collected from jugular and cephalic venipuncture in healthy horses and systemically ill horses.

DESIGN

Prospective, experimental study.

SETTING

Large animal university teaching hospital.

ANIMALS

Thirty healthy adult university-owned horses and 43 client-owned horses presenting to the large animal hospital for elective surgical procedures or for emergent medical evaluation of systemic illness.

INTERVENTIONS

Blood samples were collected from the jugular vein (JV) and cephalic vein (CV) and placed in EDTA blood tubes prior to any medical therapy. LAC values were obtained with a handheld lactate meter at the time of blood collection.

MEASUREMENTS AND MAIN RESULTS

LAC was higher in CV samples than JV samples in healthy horses (P < 0.001); however, all values were within the normal reference range. Similarly, LAC was higher in CV samples than JV samples in systemically ill horses (P < 0.001), but the median JV value was within normal reference range (1.9 mmol/L [17.1 mg/dL]), while the median CV value was outside the normal reference range (2.9 mmol/L [26.1 mg/dL]).

CONCLUSIONS

The CV is an alternative venipuncture site for assessing plasma LAC if the JV is not accessible or to preserve the JV for subsequent catheterization. However, in ill horses, the CV value may be outside the reference range when the corresponding JV value would have been within the reference range.

Epidemiology of Colic: Current Knowledge and Future Directions

Epidemiologic studies are essential for the generation of evidence-based, preventive health care strategies. This includes ways to minimize colic risk and assist informed decision making concerning diagnosis, treatment, and likely outcomes. It is important to consider that colic is not a simple "disease" but is a syndrome of abdominal pain that encompasses multiple different disease processes, and which is multifactorial in nature. This review focuses on prevention and diagnosis of colic, including specific forms of colic, communications with owners/carers concerning colic risk and management, and areas of future research.

Differentiating Strongylus vulgaris-associated, non-strangulating intestinal infarctions from idiopathic peritonitis and acute colitis in horses

BACKGROUND

Horses with non-strangulating intestinal infarction (NSII) are often misdiagnosed with idiopathic peritonitis or acute colitis. Early diagnosis is essential to ensure early surgical intervention and improve survival.

METHODS

Clinical and laboratory data from horses admitted to the University of Copenhagen Large Animal Teaching Hospital with NSII, idiopathic peritonitis or acute colitis between 2009 and 2018 were used for univariate comparisons and a multivariable logistic regression model for prediction of NSII.

RESULTS

Two hundred and thirty-one horses were included. A multivariable model for the prediction of NSII included gastric reflux (more than 5 L) (odds ratio [OR] 8.7; 95% confidence interval [CI] 2.1-36.2), abnormal findings palpated per rectum (intestinal dilatations/impactions [OR 4.43; 95% CI 1.43-13.38], colon displacements [OR 23.16; 95% CI 5.26-101.97] or intestinal mass [OR 179.7; 95% CI 23.5-1375.5]), white blood cell count (OR 1.2; 95% CI 1.1-1.4), packed cell volume (OR 0.9; 95% CI 0.8-0.9), age (OR 0.9; 95% CI 0.8-1.0) and heart rate (OR 1.1; 95% CI 1.0-1.1). The model had a low false positive rate (5%), but a high false negative rate (50%).

LIMITATIONS

Due to the retrospective nature of the study, sample collection was inconsistent, resulting in missing values.

CONCLUSION

The model had some capability in predicting NSII. However, the high risk of false negatives means that exploratory laparotomy should be considered in horses with peritonitis of unknown aetiology in areas where Strongylus vulgaris is prevalent and occurrence of idiopathic peritonitis is low.

Biomarkers of Intestinal Injury in Colic

Biomarkers are typically proteins, enzymes, or other molecular changes that are elevated or decreased in body fluids during the course of inflammation or disease. Biomarkers pose an extremely attractive tool for establishing diagnoses and prognoses of equine gastrointestinal colic, one of the most prevalent causes of morbidity and mortality in horses. This topic has received increasing attention because early diagnosis of some forms of severe colic, such as intestinal ischemia, would create opportunities for rapid interventions that would likely improve case outcomes. This review explores biomarkers currently used in equine medicine for colic, including acute phase proteins, proinflammatory cytokines, markers of endotoxemia, and tissue injury metabolites. To date, no single biomarker has been identified that is perfectly sensitive and specific for intestinal ischemia; however, L-lactate has been proven to be a very functional and highly utilized diagnostic tool. However, further exploration of other biomarkers discussed in this review may provide the key to accelerated identification, intervention, and better outcomes for horses suffering from severe colic.

Fluctuations of Physiological Variables during Conditioning of Lipizzan Fillies before Starting under Saddle

Simple Summary

Equine exercise physiological research has led to the development of scientifically sound programs that improve the physical fitness of horses. However, there are few scientific studies on the physical responses of young horses during initial training, although they are known to be sensitive to exercise overload. Our study focused on purebred Lipizzan fillies, aged 4 years in the early stages of training. To investigate the response of the fillies to a workload achieved by lunging, heart, and respiratory rates, rectal and skin temperatures, and blood parameters, cortisol and lactate concentrations were measured. All measured values, which were within a normal range for warm-blooded horses, increased after exercise due to the increased requirements of the working muscles and heat production. Despite the increase in surface temperatures of different body regions after exercise, their distributions remained unchanged. It was highest in the front regions, followed by the rear regions, and lowest in the lower parts of the legs. Our study contributes to the knowledge of physiological processes in young horses during exercise, as well as supplements research in the field of equine exercise testing, sports physiology, and animal welfare, and provides important knowledge for the conservation and development of the Lipizzan breed.

Abstract

Scientific studies on the physiological responses of young horses to workloads are limited. Therefore, the aim of our study was to determine the basal values of some cardiovascular, thermoregulatory, hematological, and biochemical parameters in 10 purebred Lipizzan fillies aged 4 years in the initial phase of training, and their responses to a graded workload, i.e., by lunging for 15 min in four exercise tests at 2-week intervals. The basal values of the measured parameters were within a range for warm-blooded horses and mostly increased after exercise in all four exercise tests. Resting heart rates were above physiological values at the baseline but decreased as the study progressed. Bilateral symmetry of body surface temperatures (BSTs) was confirmed at rest and after exercise. The highest BSTs were measured at the cranial, followed by the caudal and distal body regions. A moderate increase in cortisol and a small increase in lactate concentration indicated a low intensity of workload. The results presented contribute to the knowledge of the complex physiological processes that occur in young horses during exercise and provide a basis for further research into the field of sports physiology and welfare, as well as the conservation and development of the Lipizzan breed.

Development of a Colic Scoring System to Predict Outcome in Horses

Acute abdominal pain in the horse is a common emergency presenting to equine practices. The wide variety of etiologies makes prognosticating survival a challenge. A retrospective, multi-institutional clinical study was performed to determine clinical parameters associated with survival of horses with colic, and to use them to develop a colic survival scoring system. The scoring system was then validated using clinical data in the prospective portion of the study. Medical records from 67 horses presenting for acute abdominal pain were evaluated to develop the colic assessment score. Twenty eight variables were compared between survivors and non-survivors and entered into logistic regression models for survival. Of these, six variables were included in the colic assessment score. A total colic assessment score range was from 0 to 12, with the highest score representing the lowest probability of survival. The optimal cutoff value to predict survival was seven resulting in an 86% sensitivity and 64% specificity with a positive predictive value of 88% and a negative predictive value of 57%. Data from 95 horses presenting for abdominal pain to two equine hospitals was then collected prospectively to validate the colic assessment score. Horses from the prospective portion of the study that received a score >7 were classified as predicted to die and those with a score ≤7 were predicted to survive. The classification was compared to the actual outcome, of which the sensitivity, specificity, positive and negative predictive values of the colic assessment score were 84, 62, 88, and 52%, respectively.

Blood lactate concentrations and heart rates of Colombian Paso horses during a field exercise test

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The heart rate during the field exercise test increased according to the protocol used.

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The blood lactate concentration values during the test were remarkably dispersed.

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The mean blood lactate clearance percentage was 56.3 ± 16, similar in most animals.

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The heart rate at which a blood lactate concentration of 4 mmol/L was reached was notably different among individuals.

Information on performance indices in Paso horses is scarce. Field exercise tests are necessary to recreate the exertion that occurs during training and competition.

To describe blood lactate concentrations and heart rates of untrained Colombian Paso horses (CPHs) in response to a field exercise test.

A 30-minutes-long standardized field exercise test was carried out on 11 untrained adult CPHs of both sexes. Blood lactate concentration (BLConc) and heart rate (HR) were measured before, during each step of the test, and at recovery. The BLConc and HR were used to calculate the HR at which a BLConc of 4 mmol/L or anaerobic threshold (HRL₄) was reached.

The HR during the field exercise test increased according to the protocol used. The BLConc during the test was variable and, despite having been increasing like the HR, the distribution of the values in each step of the test was remarkably dispersed. The mean blood lactate clearance (BLClear) percentage was 56.3 ± 16, similar in most animals. The HRL₄ was reached at a notably different HR among individuals (132 to 251 bpm).

The field exercise test protocol used herein is useful to assess BLConc and HR changes in acute response to exercise in CPHs. It would be useful to evaluate training kinetics with other parameters including cell blood count and muscle enzymes.

The Physical Activity-Dependent Hematological and Biochemical Changes in School Horses in Comparison to Blood Profiles in Endurance and Race Horses

Blood testing is one of the most important ways to improve performance, facilitate recovery and monitor the training of endurance and race horses. However, little is known about the physical activity-dependent changes of blood parameters in horses used for pleasure and in riding schools. This study aimed to perform routine blood tests for training monitoring of sport horses in three different horse types of use. Then the values of blood indicators were compared between school, endurance and race horses to find similarities in the physical activity-dependent profile. The study was carried out on 15 endurance, 15 race and 15 school healthy horses who underwent the typical effort for their disciplines. The hemogram parameters, creatine phosphokinase (CPK), aspartate aminotransferase (AST), blood lactate (LAC), and total serum protein (TSP) concentrations were measured using the same protocol and equipment. Measurements of main hematological and biochemical physical activity-dependent parameters were conducted before, immediately after and 30 min after training. In school horses, the physical activity-dependent increase of WBC (40.9%) and CPK (76.4%) was similar to endurance horses, whereas an increase of RBC (19.1%), HGB (18.6%) and HCT (19.4%) were more similar to race horses. The moderate effort-dependent increase of LAC concentration (2775%) was lower than in race horses (7526%) and higher than in endurance horses (390%). Limiting the training or work monitoring assessment of school horses to only the endurance or racing blood profile may result in the omission of significant changes in hematological and biochemical parameters.

Variations in haematological and biochemical parameters in healthy ponies

Background

Breed specific reference ranges for selected blood parameters are recommended for proper interpretation of blood tests, but there are only few reports dealing with ponies. The purpose of this study was to investigate if blood parameters differ among ponies’ classes and to check if general normal values for equine species are applicable to ponies.

Results

All, except total protein concentration, biochemical parameter significantly (p < 0.05) differed among ponies’ classes. The most pronounced difference was noted in blood lactate concentrations, higher (p < 0.001) in the smallest ponies (class A). In all groups of ponies muscle enzymes (aspartate aminotransferase and creatine kinase) and urea were high when compared to normal values for equine species, but triglycerides and creatinine were low. Blood lactate concentration was high in comparison with normal values for horses only in class A ponies’.

Conclusions

In healthy ponies, blood lactate concentration significantly differs between height classes. Normal values for equine species should not be directly applied to interpret the lactate, triglycerides, aspartate aminotransferase and creatine kinase values in ponies.

Infrared Thermography Correlates with Lactate Concentration in Blood during Race Training in Horses

In horse racing the most acceptable way to objectively evaluate adaptation to increased exertion is to measure lactate blood concentration. However, this may be stressful for the horse, therefore, a simple, noninvasive procedure to monitor race progress is desirable. Forty Thoroughbreds attended race training, with blood samples collected at rest, immediately after, and 30 min after exercise. The lactate concentration was determined 60 s after blood collection using an Accusport®. Thermal imaging of the neck and trunk areas was performed following international veterinary standards from a distance of approximately 2 m from the horse using the same protocol as the blood sampling. The Spearman rank correlation coefficients (ρ) between the changes in the blood lactate concentration and surface temperature measures were found for the regions of interest. The highest positive correlation coefficients were found in the musculus trapezius pars thoracica region for the maximal temperature (T Max; ρ = 0.83; p < 0.0001), the minimal temperature (T Min; ρ = 0.83; p < 0.0001), and the average temperature (T Aver; ρ = 0.85; p < 0.0001) 30 min after the exercise. The results showed that infrared thermography may supplement blood measurements to evaluate adaptation to increased workload during race training, however, more research and references values are needed.

Prognostic value of colonic and peripheral venous lactate measurements in horses with large colon volvulus

OBJECTIVE

To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy.

STUDY DESIGN

Prospective clinical study.

ANIMALS

Forty adult horses in which large colon volvulus was diagnosed intraoperatively.

METHODS

Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant.

RESULTS

No association was found between colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large colon volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome.

CONCLUSION

Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners.

CLINICAL SIGNIFICANCE

Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.

Effect of Dexamethasone on Resting Blood Lactate Concentrations in Horses

Background

Blood lactate concentration is a marker of tissue perfusion and helps guide therapeutic interventions in critically ill horses. In both humans and dogs, administration of corticosteroids can increase blood lactate concentration, leading to type B hyperlactatemia. This effect could be a consequence of the impact of corticosteroids on glucose metabolism.

Objectives

To investigate the effects of daily IM dexamethasone administration on blood lactate and glucose concentrations in horses.

Animals

Nine healthy adult horses.

Methods

A randomized, blinded, controlled, cross‐over study design was used. Horses were randomly assigned to 1 of 2 groups, either receiving 0.05 mg/kg of dexamethasone IM or an equivalent volume of saline, daily for 7 days. Blood was collected to determine lactate and glucose concentrations at baseline, 2 hours after the daily injections and 24 hours after the last injection.

Results

Dexamethasone treatment had a statistically significant effect on lactate (P = .006) and glucose (P = .033) concentrations. The least squares mean lactate concentration was 0.93 mmol/L (95% CI: 0.87–0.99) in the dexamethasone group compared to 0.71 mmol/L (95% CI: 0.70–0.73) for the saline group. A positive relationship between blood lactate and glucose concentrations was identified, with a 0.07 mmol/L (95% CI: 0.05–0.09) increase in lactate concentration per unit increase in glucose (P < .0001) concentration.

Conclusions and Clinical Importance

Dexamethasone induces statistically significant increases in blood lactate and glucose concentrations in healthy horses. Awareness of the potential for corticosteroids to induce type B hyperlactatemia might be important in the management of critically ill horses receiving dexamethasone.