title: Use of the Accusport semi-automated analyser to determine blood lactate as an aid in the clinical assessment of horses with colic.
abstract: The most useful diagnostic methods in the initial evaluation of horses with colic assess the morphological and functional status of the gastrointestinal tract and cardiovascular status. This evaluation is best achieved using a combination of clinical and laboratory data. Blood lactate concentration (BL) is one of these variables. BL rises mainly due to poor tissue perfusion and anaerobic glycolysis associated with shock, providing an indicator of both the severity of disease and its prognosis. A hand-held lactate meter, Accusport, provides a rapid (60 seconds), inexpensive dry-chemical-based determination of BL. This trial evaluated the Accusport's ability to provide BL data as an adjunct to the initial clinical evaluation of horses with colic. The accuracy of the Accusport was tested by evaluation of its interchangeability with the benchmark enzymatic kit evaluation of BL in a trial using data collected firstly from 10 clinically normal control horses and subsequently from 48 horses presented with signs of colic. The BL values were recorded together with the clinical variables of heart rate (HR), capillary refill time (CRT), haematocrit (Hct), and pain character and severity on the initial assessment of the colic horses. Information regarding choice of therapeutic management (medical or surgical) and eventual case outcome (full recovery or died/euthanased) was recorded. The Accusport was found to be interchangeable with the enzymatic kit for recording BL values in colic horses with BL < 10 mmol/l, which is within the BL range associated with survival. The interchangeability of an additional, laboratory-based wet chemical assay for BL, the Stat 7 was simultaneously evaluated for the colic and control horses. The Stat 7 was found to be interchangeable with the enzymatic kit for BL determination of colic horses. No linear associations between BL values with HR, CRT, Hct or pain assessment were observed. No relationship with either selection of therapeutic method or eventual case outcome was observed. All horses with BL >8 mmol/l died or were euthanased.
authors.affiliation: Department of Reproduction, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
authors.forename: M L
authors.initials: ML
authors.lastname: Schulman
authors.forename: J P
authors.initials: JP
authors.lastname: Nurton
authors.forename: A J
authors.initials: AJ
authors.lastname: Guthrie
mesh_terms: D000818:Animals; D001774:Blood Chemical Analysis / Q000295:instrumentation / Q000662:veterinary*; D016022:Case-Control Studies; D003085:Colic / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D006734:Horse Diseases / Q000097:blood* / Q000175:diagnosis; D006736:Horses; D019344:Lactic Acid / Q000032:analysis / Q000097:blood*; D011379:Prognosis; D011933:Reagent Kits, Diagnostic / Q000662:veterinary; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D011933:Reagent Kits, Diagnostic; D019344:Lactic Acid