Peritoneal and plasma D-lactate concentrations in horses with colic.
Authors: Yamout Sawsan Z, Nieto Jorge E, Beldomenico Pablo M, Dechant Julie E, leJeune Sarah, Snyder Jack R
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Distinguishing between strangulating and non-strangulating colic lesions remains one of the greatest diagnostic challenges in equine practice, with significant implications for surgical decision-making and prognosis. Yamout *et al.* measured D-lactate concentrations in both peritoneal fluid and plasma from 90 colicky horses and six healthy controls, correlating these values with established diagnostic variables, surgical findings, and clinical outcomes. Peritoneal D-lactate proved a strong indicator of intestinal compromise: horses with septic peritonitis and gastrointestinal rupture showed median concentrations of 455.2 and 599.5 µmol/L respectively, compared with just 77.7 µmol/L in non-strangulating obstructions, and higher peritoneal D-lactate concentrations were significantly associated with poor survival. Using a peritoneal D-lactate threshold of 116.6 µmol/L achieved 81.3% sensitivity for detecting strangulating lesions, though specificity was moderate at 65.1%, meaning the test is valuable for *confirming* intestinal strangulation but less reliable for ruling it out. For practitioners, this suggests that elevated peritoneal D-lactate should substantially raise suspicion of strangulation and support surgical intervention, whilst a normal value cannot safely exclude serious pathology and should not delay referral when clinical signs indicate colic severity.
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Practical Takeaways
- •Peritoneal D-lactate measurement is useful for identifying strangulating obstructions with high sensitivity—a negative result makes strangulation less likely but cannot rule it out entirely
- •Elevated peritoneal D-lactate is strongly associated with poor prognosis; use alongside other clinical indicators to guide urgency of surgical intervention
- •D-lactate can be measured from abdominocentesis fluid, making it a practical adjunct diagnostic tool available during the colic workup without additional invasive procedures
Key Findings
- •Peritoneal D-lactate concentration strongly correlated with plasma D-lactate (r=0.71, P<0.001), with both increasing in strangulating lesions
- •Peritoneal D-lactate was negatively correlated with survival to discharge, indicating prognostic value
- •Cut-off of 116.6 μmol/L peritoneal D-lactate had 81.3% sensitivity and 65.1% specificity for detecting strangulating vs nonstrangulating obstructions
- •Septic peritonitis (455.2 μmol/L) and gastrointestinal rupture (599.5 μmol/L) showed substantially higher D-lactate than nonstrangulating obstructions (77.7 μmol/L)