Acute phase response to surgery of varying intensity in horses: a preliminary study.
Authors: Jacobsen Stine, Nielsen Jon Vedding, Kjelgaard-Hansen Mads, Toelboell Trine, Fjeldborg Julie, Halling-Thomsen Maj, Martinussen Torben, Thoefner Martin Bang
Journal: Veterinary surgery : VS
Summary
# Editorial Summary This 2009 study examined how horses mount an inflammatory response to surgery of different scales—arthroscopy for osteochondritis (minimal trauma), laryngoplasty for laryngeal neuropathy (intermediate trauma), and ovariectomy via laparotomy (major trauma)—by measuring serum amyloid A (SAA), fibrinogen, iron, and white blood cell counts daily for 11 days post-operatively across 26 horses. The researchers found that SAA and fibrinogen concentrations increased proportionally with surgical intensity, with the laparotomy group showing significantly elevated markers compared to both the laryngoplasty and arthroscopy groups, whilst iron levels decreased more sharply following intermediate and major procedures than minor ones; notably, white blood cell counts failed to differentiate between surgical groups. These findings suggest that SAA, fibrinogen, and iron are sensitive markers of surgical trauma magnitude and may help standardise comparisons when evaluating new surgical techniques or modifications to existing ones. For clinical practitioners, understanding the expected acute phase response trajectory is crucial for distinguishing between normal post-operative inflammation and early signs of infection or complication, particularly when interpreting blood results in the critical 1–11 day window following elective procedures.
Read the full abstract on PubMed
Practical Takeaways
- •Monitoring SAA and fibrinogen levels postoperatively can help you assess whether the inflammatory response is proportional to the surgical procedure performed—unusually elevated levels may indicate infection or complications
- •WBC counts alone are insufficient for postoperative infection monitoring; use acute phase proteins (SAA, fibrinogen) and iron levels alongside clinical signs for better detection of problems
- •Understanding the expected inflammatory response timeline (peaks at days 1-3, gradually declining by day 11) helps you distinguish normal healing from pathological inflammation when evaluating recovery
Key Findings
- •Serum amyloid A (SAA) and fibrinogen concentrations increased proportionally to surgical trauma intensity, with laparotomy showing significantly higher levels than arthroscopy or laryngoplasty
- •Iron concentrations decreased more markedly after intermediate and major surgical trauma compared to minimal trauma
- •White blood cell count did not differ between surgical groups despite varying trauma intensity
- •SAA, fibrinogen, and iron are useful biomarkers for assessing surgical trauma severity and may help distinguish normal postoperative inflammation from postoperative infection