Concentrations of neutrophil gelatinase-associated lipocalin are increased in serum and peritoneal fluid from horses with inflammatory abdominal disease and non-strangulating intestinal infarctions.
Authors: Winther Malou F, Haugaard Simon L, Pihl Tina H, Jacobsen Stine
Journal: Equine veterinary journal
Summary
# Editorial Summary Differentiating non-strangulating intestinal infarction (NSII) from other causes of peritonitis remains clinically challenging, yet early surgical intervention is critical for survival in affected horses. This retrospective analysis of 270 horses with acute abdominal disease examined neutrophil gelatinase-associated lipocalin (NGAL)—an inflammatory biomarker—measured in serum and peritoneal fluid to determine whether it could distinguish between simple obstructions, strangulating obstructions, inflammatory abdominal disease, and NSII. Healthy control horses showed baseline NGAL concentrations of 21.0 µg/L (serum) and 9.5 µg/L (peritoneal fluid), whilst simple and strangulating obstructions failed to elevate NGAL above these baseline values; however, horses with NSII exhibited dramatically elevated peritoneal fluid NGAL (2163.0 µg/L), approximately seven-fold higher than those with inflammatory disease alone (314.1 µg/L), suggesting NGAL's potential utility as a discriminatory biomarker for this particularly difficult diagnosis. For equine practitioners, peritoneal fluid NGAL measurement may offer a practical tool to identify horses requiring immediate surgical exploration, though the retrospective design and small control group warrant validation through prospective studies before clinical implementation.
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Practical Takeaways
- •NGAL measurement in peritoneal fluid may help differentiate non-strangulating intestinal infarction from other types of peritonitis, potentially enabling faster surgical decision-making in cases that are clinically difficult to distinguish
- •NGAL is useful as an inflammatory marker in abdominal disease but does not reliably discriminate between obstructive colic types; clinical findings and other diagnostics remain essential
- •Peritoneal fluid NGAL shows greater discriminatory value than serum NGAL for identifying NSII, suggesting abdominocentesis analysis should be prioritized when this condition is suspected
Key Findings
- •Healthy horses had low NGAL concentrations in serum (21.0 μg/L) and peritoneal fluid (9.5 μg/L)
- •Horses with NSII had markedly elevated peritoneal fluid NGAL (2163.0 μg/L) compared to all other groups (p < 0.001)
- •Horses with inflammatory abdominal disease also showed increased serum (171.1 μg/L) and peritoneal fluid (314.1 μg/L) NGAL, but lower than NSII
- •Simple and strangulating intestinal obstructions did not show significantly elevated NGAL compared to healthy controls