Determination of lactate concentrations in blood plasma and peritoneal fluid in horses with colic by an Accusport analyzer.
Authors: Delesalle Cathérine, Dewulf Jeroen, Lefebvre Romain A, Schuurkes Jan A J, Proot Joachim, Lefere Laurence, Deprez Piet
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary Lactate accumulation in blood and peritoneal fluid reflects intestinal hypoperfusion in colicky horses, but the practical value of measuring these markers has remained unclear. Researchers tested the Accusport analyser—a portable lactate meter—on 20 healthy horses and 106 with colic, measuring both blood plasma lactate (BPL) and peritoneal fluid lactate (PFL) to evaluate reliability and prognostic accuracy. The analyser proved reliable for BPL concentrations below 13 mM and PFL below 20 mM, with PFL demonstrating substantially greater prognostic utility than BPL; each 1 mM increase in PFL increased the odds of requiring intestinal resection by 1.41 and raised mortality risk from 11% (at 1 mM) to 82% (at 16 mM) in non-strangulating cases, and from 25% to 92% respectively in strangulating obstructions. For practitioners, peritoneal fluid analysis offers a readily accessible, quantifiable measure of tissue viability at abdominocentesis that correlates closely with surgical necessity, tissue necrosis, and survival outcome—making it substantially more discriminatory than blood lactate values alone for clinical decision-making in acute colic cases.
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Practical Takeaways
- •Peritoneal fluid lactate measurement is more prognostically valuable than blood lactate in colic cases—prioritize PFL sampling when available
- •PFL concentrations can guide clinical decision-making: values >6 mM warrant aggressive intervention and guarded prognosis discussions with owners
- •The Accusport analyzer is reliable for field or clinic use up to 13 mM (BPL) and 20 mM (PFL), making it practical for rapid prognostic assessment in colic cases
Key Findings
- •Accusport analyzer reliably measures blood plasma lactate concentrations <13 mM and peritoneal fluid lactate <20 mM in horses
- •Peritoneal fluid lactate (PFL) is more sensitive and prognostically useful than blood plasma lactate (BPL) for predicting outcomes in equine colic
- •Each 1 mM increase in PFL increases odds ratio for required abdominal surgery to 1.58 and intestinal resection to 1.41
- •PFL concentrations of 1, 6, 12, and 16 mM correspond to mortality probabilities of 11%, 29%, 63%, and 82% respectively in non-strangulating colic, and 25%, 52%, 82%, and 92% in strangulating obstruction