Alactic base excess is not a sensitive or specific diagnostic tool for outcome in horses with colic.
Authors: Crosby Corinne E, O'Connor Annette, Munsterman Amelia S
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Alactic Base Excess in Equine Colic Identifying horses with surgical versus medical colic remains challenging despite advances in diagnostic imaging and clinical pathology, with prognostic biomarkers remaining an important area of investigation. Crosby and colleagues conducted a retrospective analysis evaluating alactic base excess (ABE)—a measure derived from blood gas analysis that excludes lactate-related acid–base disturbances—as a potential diagnostic and prognostic tool in horses presenting with gastrointestinal disease. Although ABE has demonstrated clinical utility in human medicine for identifying mortality risk and renal dysfunction, the researchers found it to be neither sensitive nor specific for distinguishing surgical from medical colic cases or for predicting mortality outcomes in horses. Given the widespread availability of point-of-care blood gas analysers in equine practice, the temptation to adopt ABE as a decision-making tool may be considerable; however, this work suggests that clinicians cannot rely on ABE values alone to guide case management or prognostication. Practitioners should continue to integrate ABE findings—where measured—within the broader clinical context of physical examination, imaging findings, and traditional acid–base parameters rather than treating it as an independent predictor of outcome.
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Practical Takeaways
- •Do not rely on ABE alone as a diagnostic or prognostic tool when evaluating colic cases—continue using established clinical and laboratory assessment protocols
- •Recognize that despite extensive research, no single blood marker exists that can definitively predict which colic cases need surgery or how they will progress, so comprehensive clinical evaluation remains essential
- •Consider ABE as part of a broader metabolic assessment rather than a standalone decision-making tool for surgical vs. medical management
Key Findings
- •Alactic base excess (ABE) does not reliably distinguish surgical from medical colic in horses
- •ABE is not a sensitive or specific biomarker for predicting mortality in equine colic cases
- •No single biomarker has been identified that can effectively differentiate surgical from medical colic or predict outcomes