Evaluation of L-lactate and cardiac troponin I in horses undergoing emergency abdominal surgery.
OBJECTIVE
To evaluate changes in plasma cardiac troponin I (cTnI) and L-lactate (LLt) as prognostic indicators in horses undergoing emergency abdominal surgery.


METHODS
Prospective observational study.


METHODS
Veterinary teaching hospital.


METHODS
Thirty-four horses undergoing emergency abdominal surgery.


METHODS
Serial blood sampling during various times during hospitalization (hospital admission, and 12, 24, 48, and 72 h postoperatively) evaluating cTnI and LLt concentrations.


RESULTS
All horses required surgery for correction of a strangulating (n = 29) or nonstrangulating obstruction (n = 5) of the small or large intestine. Twenty-seven horses survived to discharge; 7 were euthanized either during (n = 1) or after (n = 6) surgery due to disease severity or systemic complications associated with the primary gastrointestinal lesion. Preoperative cTnI concentrations were increased above the normal reference interval in 24% of horses (8/34, median = 0.01 ng/mL, range = 0-12.23 ng/mL), whereas LLt concentrations were increased above the normal reference interval in 88% of horses (30/34, median = 3.37 mmol/L, range = 0.77-13.26 mmol/L). The LLt concentration was significantly higher (P < 0.05) in nonsurviving compared with surviving horses at admission, and at 24 and 72 hours postoperatively. No significant difference in the cTnI concentration was detected between groups at admission. However, the cTnI concentration was significantly higher (P<0.05) in nonsurviving compared with surviving horses at all time points postoperatively.


CONCLUSIONS
Measurement of both LLt and cTnI concentrations may provide information for prognostication in surgical colic horses. Marked increases in admission concentrations of LLt (median 7.56 mmol/L) and even moderate postoperative increases in cTnI concentration (median 0.97 ng/mL) may both indicate a poor prognosis in critically ill horses following abdominal surgery.
Department of Clinical Studies, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA. rmr45@cornell.edu
Rolfe M
RM
Radcliffe
Thomas J
TJ
Divers
Daniel J
DJ
Fletcher
Hussni
H
Mohammed
Marc S
MS
Kraus
D015746:Abdominal Pain / Q000097:blood / Q000601:surgery / Q000662:veterinary; D000818:Animals; D004630:Emergencies / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000097:blood* / Q000601:surgery; D006736:Horses; D007415:Intestinal Obstruction / Q000097:blood / Q000601:surgery / Q000662:veterinary*; D045822:Intestinal Volvulus / Q000097:blood / Q000601:surgery / Q000662:veterinary; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D011379:Prognosis; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*
D019210:Troponin I; D019344:Lactic Acid