Clinicopathologic Parameters of Peritoneal Fluid as Predictors of Gastrointestinal Lesions, Complications, and Outcomes in Equine Colic Patients: A Retrospective Study.
Authors: Martin Emily, Sarkan Kate, Viall Austin, Hostetter Shannon, Epstein Kira
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Peritoneal fluid analysis is routinely performed during equine colic cases, yet interpreting the clinical significance of specific parameters remains challenging for practitioners. This retrospective examination of 342 colic cases analysed neutrophil characteristics alongside total protein and lactate levels in peritoneal fluid to determine whether these markers could reliably predict lesion severity, postoperative complications, and patient outcomes. Horses with strangulating intestinal lesions demonstrated markedly elevated peritoneal neutrophil percentages, absolute neutrophil counts, and total nucleated cell counts compared to those with non-strangulating conditions, whilst the development of postoperative reflux or systemic inflammatory response syndrome was strongly associated with increased peritoneal neutrophils, total protein, and lactate levels. Notably, non-survivors showed significantly higher peritoneal neutrophil counts, total protein, lactate, and a greater ratio of peritoneal-to-blood protein concentration than those discharged, suggesting these parameters may reflect intestinal barrier compromise and septic sequelae. These findings suggest that quantitative neutrophil analysis in peritoneal fluid—beyond simple visual assessment—could help practitioners identify high-risk cases earlier, stratify surgical candidates more accurately, and potentially guide targeted interventions aimed at modulating the inflammatory cascade underlying colic-related mortality and morbidity.
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Practical Takeaways
- •Elevated neutrophils and inflammatory markers in peritoneal fluid analysis can help differentiate strangulating from non-strangulating colic lesions, guiding surgical decision-making
- •High peritoneal fluid protein and lactate values should alert practitioners to increased risk of serious complications (SIRS, postoperative reflux) and mortality, allowing for more aggressive monitoring and intervention
- •Peritoneal fluid analysis remains a valuable diagnostic and prognostic tool in equine colic cases, with neutrophil characteristics potentially identifying horses at higher risk of poor outcomes
Key Findings
- •Horses with strangulating lesions had significantly higher peritoneal fluid % neutrophils, absolute neutrophil count, and TNCC compared to non-strangulating lesions
- •Development of SIRS or postoperative reflux was associated with higher PF TNCC, total neutrophil count, total protein, and lactate
- •Non-survivors had increased PF % neutrophils, neutrophil count, total protein, lactate, and PF-to-systemic protein ratio compared to survivors
- •Peritoneal fluid neutrophil characteristics may serve as prognostic indicators for complications and mortality in equine colic patients