Serial postoperative peritoneal fluid analyses in horses with naturally-occurring strangulating and non-strangulating gastrointestinal lesions.
Authors: Granello Maria E, Young Jenna M, Cleff Dana B, Banks Emma B M, Trumble Troy N
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Researchers tracked peritoneal fluid changes in 26 horses undergoing abdominal surgery for colic, collecting samples before operation and at 24, 72, and 168 hours post-surgery to compare animals with strangulating lesions (n=14) against those with non-strangulating pathology (n=12). Peritoneal lactate and total protein concentrations were significantly elevated pre-operatively in strangulating cases, though this distinction dissolved postoperatively; however, both markers remained pathologically high throughout the entire week-long study period in both groups, despite systemic lactate normalising within 24 hours. Total nucleated cell counts in peritoneal fluid increased significantly at 24 hours post-surgery in both lesion types, reflecting the expected inflammatory response to surgical intervention. The persistence of elevated peritoneal lactate and protein beyond one week has important diagnostic ramifications: clinicians cannot reliably use standard reference intervals to interpret postoperative abdominal fluid samples, as these indices remain abnormal well after systemic markers have resolved. This finding underscores the need for caution when performing postoperative abdominocentesis, particularly if assessing peritoneal health during the early recovery phase—the discrepancy between local peritoneal inflammation and systemic parameters suggests that rechecking abdominal fluid characteristics should be interpreted with knowledge of the postoperative timeline rather than relying on traditional normal ranges.
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Practical Takeaways
- •Elevated peritoneal lactate and protein at 1 week post-surgery do not indicate treatment failure or ongoing pathology—this is a normal postoperative finding regardless of lesion type
- •Do not use preoperative peritoneal fluid reference values to interpret postoperative samples; establish separate postoperative reference ranges for clinical decision-making
- •Systemic lactate normalization by 24 hours is a favorable prognostic indicator even when peritoneal fluid parameters remain abnormal
Key Findings
- •Peritoneal lactate and total protein were significantly higher preoperatively in strangulating versus non-strangulating lesions (p<0.001 and p=0.02 respectively)
- •Peritoneal lactate and protein concentrations remained elevated above normal throughout the entire 1-week postoperative period in both lesion groups
- •Systemic lactate normalized by 24 hours postoperatively in both groups, while peritoneal lactate remained elevated
- •Peritoneal total nucleated cell count increased significantly at 24 hours postoperatively in both strangulating (p=0.001) and non-strangulating (p<0.001) lesion groups