Validation of a point-of-care handheld blood total calcium analyzer in postpartum dairy cows

Evaluation of a point-of-care calcium device in bovine plasma and serum

Hypocalcemia is a common metabolic disease in dairy cows, and it is defined as total calcium (tCa) blood concentration <2.0 mmol/L. The alternatives for the gold standard test to measure tCa in bovine blood are limited. Therefore, our objective was to compare the performance of the calcium (Ca) point-of-care compact analyzer (POC; ARKRAY Inc.) device with the gold standard method to measure bovine blood tCa concentration. Blood samples (n = 151) from dairy cows were collected within 24 h postpartum from multiparous and primiparous dairy cows for serum and plasma. Then, serum and plasma were stored at -80°C until further analyses with the gold standard method on an automatic analyzer (Cobas C501 analyzer; Roche Diagnostics) and the POC device. The tCa blood concentration was measured in the laboratory in plasma and serum samples using both methods within 10 mo of sample collection. Correlation coefficients (Spearman), coefficients of variation (CV, %), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, Passing and Bablok regression, and Bland-Altman agreement test were performed between the gold standard and the POC device. The range and median tCa plasma concentrations measured with the POC device were 1.1 to 2.8 mmol/L and 2.4 mmol/L, respectively. The range and median tCa serum concentrations measured with the POC device were 1.1 to 2.7 mmol/L and 2.3 mmol/L, respectively. The tCa blood concentrations range and median with the gold standard were 1.1 to 2.6 mmol/L and 2.3 mmol/L. The hypocalcemia prevalence of our study population was 11.2%. The CV were 1.89% and 0.55% for low and high tCa in plasma samples measured with the POC, respectively. The CV were 2.57% and 1.58% for low and high tCa in serum, respectively. The Spearman correlation coefficient showed a strong correlation between the gold standard and the POC device for both serum and plasma tCa concentration. The sensitivity of the POC device for both plasma (41.1%) and serum (64.7%) Ca was poor. However, the specificity of the POC device was perfect in plasma (99.2%) and serum (99.2%). The PPV in plasma and serum were 87.5% and 91.6%, respectively. Negative predicted values were 93.0% and 95.6% in plasma and serum. The mean (95% CI) difference between the gold standard and the POC device in plasma and serum were 0.35 (-0.52, 1.23) mmol/L and 0.19 (-0.53, 0.92) mmol/L, respectively. Finally, we observed a strong correlation between the POC device and the gold standard method for tCa plasma and serum. However, the clinical application of the POC device should be carefully considered because its ability to detect cows with hypocalcemia in serum or plasma samples was poor. However, the device performed better than previously analyzed POC devices and needs further improvement to be a valuable tool for the dairy industry.

Considerations in the Diagnosis and Treatment of Early Lactation Calcium Disturbances

This article reviews the history of clinical hypocalcemia and the evolving definition of subclinical hypocalcemia, targeting a concept for consideration that not all hypocalcemia is negative. With a goal of presenting bovine practitioners information to assist with individual animal hypocalcemia diagnosis and treatment as well as herd-level monitoring and prevention, we present current methods of direct calcium measurement, therapeutic interventions for clinical hypocalcemia, and postpartum calcium supplementation options and their efficacy. We encourage veterinarians to understand calcium dynamics in the immediate postpartum period and evaluate how individual cow therapy and herd prevention protocols can assist with supporting calcium regulation.

Prediction of Liver Triglyceride Content in Early Lactation Multiparous Holstein Cows Using Blood Metabolite, Mineral, and Protein Biomarker Concentrations

Bovine fatty liver syndrome (bFLS) is difficult to diagnose because a liver tissue biopsy is required to assess liver triglyceride (TG) content. We hypothesized that a blood biomarker panel could be a convenient alternative method of liver TG content assessment and bFLS diagnosis. Our objectives were to predict liver TG using blood biomarker concentrations across days in milk (DIM; longitudinal, LT) or at a single timepoint (ST; 3, 7, or 14 DIM), as well as different biomarker combination based on their perceived accessibility. Data from two separate experiments (n = 65 cows) was used for model training and validation. Response variables were based on the maximum liver TG observed in 1 and 14 DIM liver biopsies: Max TG (continuous), Low TG (TG > 13.3% dry matter; DM), Median TG (TG > 17.1% DM), and High TG (TG > 22.0% DM). Model performance varied but High TG was well predicted by sparse partial least squares—discriminate analysis models using LT and ST data, achieving balanced error rates ≤ 15.4% for several model variations during cross-validation. In conclusion, blood biomarker panels using 7 DIM, 14 DIM, or LT data may be a useful diagnostic tool for bFLS in research and field settings.