Peritoneal bile acids concentration in adult horses with hepatic and gastrointestinal disorders.
Authors: Rodríguez-Pozo Maria L, Armengou Lara, Viu Judit, Ríos Jose, Jose-Cunilleras Eduard
Journal: Equine veterinary journal
Summary
# Peritoneal Bile Acids as a Diagnostic and Prognostic Marker in Equine Abdominal Disease Bile acids in peritoneal fluid have never been characterised in horses until now, despite a clinical case of liver lobe torsion suggesting their diagnostic potential. This prospective study measured plasma and peritoneal bile acid concentrations in 108 horses with hepatic or gastrointestinal disease alongside 11 healthy controls, stratifying patients by diagnosis (hepatic disease, obstructive colic, and ischaemic-inflammatory colic) and clinical outcome. Horses with primary hepatic disease exhibited markedly elevated peritoneal bile acid concentrations (median 6.8 µmol/L) compared to healthy controls (1.0 µmol/L) and obstructive colic cases (1.2 µmol/L), whilst ischaemic-inflammatory colic also showed significantly raised values (3.3 µmol/L). Critically, non-surviving horses demonstrated substantially higher peritoneal bile acid concentrations (4.1 µmol/L) than survivors (1.3 µmol/L), suggesting prognostic value independent of diagnosis. For equine practitioners managing abdominal pain cases, peritoneal bile acid analysis may help differentiate between disease categories and identify higher-risk patients, though further work with larger cohorts is needed to establish its clinical utility in routine practice.
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Practical Takeaways
- •PBAC measurement may help differentiate hepatic disease from GI obstruction in horses with abdominal pain, with hepatic cases showing substantially elevated values
- •Elevated PBAC appears to correlate with poor prognosis; horses with higher peritoneal bile acid levels had significantly worse survival outcomes
- •This biomarker could support clinical decision-making in acute abdominal cases, but larger studies are needed before routine clinical application
Key Findings
- •Peritoneal bile acids concentration (PBAC) reference range in healthy horses is 1.0 [0.6-1.5] µmol/L
- •Hepatic disease horses had significantly higher PBAC (6.8 [2.3-9.4] µmol/L) compared to controls and GI obstructive groups
- •GI ischaemic-inflammatory disease horses showed elevated PBAC (3.3 [1.4-5.5] µmol/L) compared to controls and obstructive groups
- •Non-survivor horses had significantly higher PBAC (4.1 [1.6-6.5] µmol/L) than survivors (1.3 [0.8-3] µmol/L), suggesting prognostic value