Effects of surgery on the acute phase response in clinically normal and diseased horses.
Authors: Pollock P J, Prendergast M, Schumacher J, Bellenger C R
Journal: The Veterinary record
Summary
# Editorial Summary Pollock and colleagues investigated how surgical trauma triggers the acute phase response in horses by measuring three key inflammatory markers—serum amyloid A (SAA), haptoglobin and fibrinogen—before surgery and at intervals afterwards in both elective and emergency surgical cases, alongside healthy controls. Serum amyloid A proved the most dramatic and reliable indicator of surgical stress, rising to mean peak concentrations of 16.4 µg/ml within 24 hours of elective procedures and 27.3 µg/ml following non-elective surgery, compared with baseline values of 0–0.2 µg/ml in clinically normal horses. By contrast, haptoglobin and fibrinogen showed a slower, more protracted inflammatory response that remained elevated at 72 hours post-operatively. These findings have important implications for post-operative monitoring and recovery assessment: SAA's rapid and substantial elevation makes it a sensitive marker for detecting surgical complications or infection early, whilst the sustained elevation of haptoglobin and fibrinogen suggests that single-point measurements may be less informative for gauging recovery trajectory. For practitioners managing post-operative cases, understanding this temporal pattern of acute phase proteins can help differentiate normal post-surgical inflammation from potentially problematic complications warranting intervention.
Read the full abstract on PubMed
Practical Takeaways
- •Serum amyloid A is a sensitive early marker of surgical trauma in horses; non-elective surgery produces a more pronounced inflammatory response than elective procedures
- •Expect prolonged elevation of haptoglobin and fibrinogen for at least 3 days post-surgery; monitor these parameters when assessing post-operative recovery
- •Use acute phase protein measurements to differentiate between surgical stress responses and potential post-operative complications in clinically normal versus diseased horses
Key Findings
- •Serum amyloid A increased significantly and rapidly after both elective and non-elective surgery, with peak mean concentration of 16.4 microg/ml at 24 hours post-elective surgery and 27.3 microg/ml after non-elective surgery
- •Non-elective surgery triggered a substantially higher acute phase response (27.3 vs 16.4 microg/ml) compared to elective surgery
- •Haptoglobin and fibrinogen increased more slowly than serum amyloid A and remained elevated at 72 hours post-surgery
- •Control horses maintained normal serum amyloid A concentrations of 0-0.2 microg/ml