Peritoneal fluid analysis in equine post-partum emergencies admitted to a referral hospital: A retrospective study of 110 cases.
Authors: Offer Katie S, Russell Catherine M, Carrick Joan B, Wallington Caitlin E, Cudmore Lucy A, Cuming Rosemary S, Collins Niamh M
Journal: Equine veterinary journal
Summary
# Peritoneal Fluid Analysis in Post-Partum Mares: Diagnostic Value in Emergency Cases Distinguishing between gastrointestinal, urogenital and haemorrhagic emergencies in post-partum mares is clinically challenging, yet rapid diagnosis directly impacts treatment decisions and prognosis; peritoneal fluid analysis offers potential diagnostic utility in this context, though its value in post-partum presentations remains poorly characterised. Researchers retrospectively analysed peritoneal fluid samples from 110 Thoroughbred mares admitted to a referral hospital with post-partum emergencies, stratifying cases by primary diagnosis (gastrointestinal tract disease 30%, urogenital trauma 50%, post-partum haemorrhage 20%) and comparing fluid parameters including packed cell volume, white blood cell count and cytological findings. Post-partum haemorrhage cases demonstrated significantly elevated peritoneal fluid PCV alongside reduced white blood cell counts and an absence of degenerate neutrophils on cytology, whereas these parameters differed significantly across diagnostic categories, though no single factor proved uniformly diagnostic. The practical implication is that whilst peritoneal fluid analysis cannot definitively diagnose post-partum emergencies in isolation, the pattern of findings—particularly higher PCV combined with a non-septic inflammatory profile—strengthens suspicion for haemorrhagic rather than infectious or obstructive pathology, potentially expediting appropriate clinical management. The 55% overall survival rate and retrospective design warrant cautious interpretation, yet these findings provide a foundation for integrating peritoneal fluid analysis into the diagnostic algorithm for post-partum mares presenting with abdominal signs.
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Practical Takeaways
- •Peritoneal fluid analysis is a useful diagnostic tool in post-partum mares presenting with emergency colic-like signs; interpret results in the context of clinical presentation as no single finding is pathognomonic
- •Higher peritoneal PCV with lower cell counts and non-degenerate neutrophils suggests haemorrhage rather than septic peritonitis, guiding urgency and type of intervention
- •Plan for aggressive fluid resuscitation and close monitoring in post-partum emergencies, as overall survival is approximately 55% even at referral centres
Key Findings
- •Of 110 post-partum mares, 50% presented with urogenital trauma, 30% with GIT disease, and 20% with post-partum haemorrhage
- •Peritoneal fluid PCV, WBCC, and cytology (presence/absence of degenerate neutrophils) differed significantly between diagnostic categories
- •Higher peritoneal fluid PCV, absence of degenerate neutrophils, and lower WBCC were associated with increased likelihood of PPH diagnosis
- •Overall survival to discharge was 55%, with peritoneal fluid analysis aiding diagnosis but no single factor being uniformly diagnostic