Serum amyloid A, haptoglobin, and ferritin in horses with colic: Association with common clinicopathological variables and short-term outcome.
Authors: Dondi Francesco, Lukacs Robert M, Gentilini Fabio, Rinnovati Riccardo, Spadari Alessandro, Romagnoli Noemi
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Acute phase proteins (APPs) are increasingly recognised as markers of systemic inflammation in equine colic, yet their clinical utility remains poorly defined. This retrospective analysis of 54 colic cases examined serum amyloid A (SAA), haptoglobin, and ferritin alongside standard clinicopathological variables to assess their association with colic type and short-term survival outcomes. The researchers found that abnormal concentrations were common—affecting 54% of horses for SAA, 37% for haptoglobin, and 57% for ferritin—with particularly striking differences between survivors and non-survivors: non-survivors exhibited significantly depressed haptoglobin and elevated ferritin levels, whilst horses with ischaemic or strangulating lesions showed elevated creatinine and ferritin with concurrent haptoglobin suppression compared to medical colics. Despite these associations, creatinine emerged as the only statistically significant predictor of mortality in logistic regression analysis, suggesting that whilst APPs may reflect pathophysiological changes such as haemolysis, muscle damage, and altered iron metabolism, they do not independently improve prognostic accuracy beyond conventional biochemical markers on admission. For practitioners, these findings support using APP measurements as complementary tools to interpret the severity and nature of colic-associated tissue damage and systemic response, but not as standalone prognostic indicators; further prospective research is needed to establish whether serial APP monitoring during treatment offers superior prognostic value.
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Practical Takeaways
- •Measure acute phase proteins (SAA, haptoglobin, ferritin) alongside standard clinicopathological parameters on admission to gain insights into colic pathogenesis and potential complications
- •Low haptoglobin and elevated ferritin suggest haemolysis or muscle damage and may indicate poorer prognosis; use these patterns to help risk-stratify cases
- •Serum creatinine remains the most reliable predictor of mortality; prioritize this marker in prognostic assessment alongside APP patterns
Key Findings
- •High percentages of horses with abnormal acute phase proteins: SAA in 54%, haptoglobin in 37%, and ferritin in 57% of cases
- •Non-survivors had significantly decreased haptoglobin and increased ferritin compared to survivors
- •Ischaemic/strangulating colic group showed increased creatinine and ferritin with decreased haptoglobin versus non-ischaemic group
- •Creatinine was the only statistically significant predictor of mortality in logistic regression analysis