Blood and peritoneal lactate in equine colic: application in emergency care and construction of a decision tree
Authors: A. Barros, M.M. Camargo, M. Nichi, C. Belli
Journal: Arquivo Brasileiro de Medicina Veterinária e Zootecnia
Summary
# Editorial Summary: Blood and Peritoneal Lactate as Prognostic Markers in Equine Colic Prognosis in equine colic remains challenging, and clinicians require reliable biochemical indicators to guide decision-making in the critical first 24 hours. Barros and colleagues conducted a retrospective analysis of 339 colic cases using blood lactate and peritoneal fluid lactate measurements alongside clinical parameters including heart rate and dehydration severity, applying machine learning algorithms to identify predictive patterns associated with short-term mortality. Peritoneal lactate showed strong negative correlation with the blood-to-peritoneal lactate ratio and moderate positive correlation with dehydration percentage, suggesting these markers reflect different aspects of tissue perfusion and visceral compromise. The researchers successfully constructed two decision trees achieving over 80% accuracy in predicting survival beyond 24 hours of hospitalisation, offering practitioners a validated framework for rapidly assessing prognosis at admission. For equine veterinarians managing acute colic cases, these models could substantially improve early risk stratification and inform discussions around medical versus surgical intervention, particularly when combined with standard vital parameters and peritoneal analysis already performed in emergency assessment.
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Practical Takeaways
- •Measuring both blood and peritoneal lactate, along with their ratio, can help predict which colic cases are likely to die within 24 hours with >80% accuracy—use the constructed decision trees to inform client discussions about prognosis
- •Peritoneal lactate correlates with dehydration severity, making it a useful marker alongside standard physical examination findings for assessing colic severity
- •The BL:PL ratio appears to be a key prognostic indicator; higher ratios suggest better short-term survival prospects
Key Findings
- •Peritoneal lactate was strongly negatively correlated with blood lactate-to-peritoneal lactate ratio (p<0.05)
- •Peritoneal lactate was moderately positively correlated with dehydration severity percentage (p<0.05)
- •Two decision tree models achieved >80% accuracy in predicting 24-hour mortality in horses with colic
- •Blood lactate and peritoneal lactate measurements correlate with heart rate and dehydration in colic cases