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Equine Vet J. 2019 Mar 26. doi: 10.1111/evj.13117. [Epub ahead of print]

Serum amyloid A and plasma fibrinogen concentrations in horses following emergency exploratory celiotomy.

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1
Bell Equine Veterinary Clinic, 104 Butchers Lane, Mereworth, Maidstone, Kent, ME18 5GS, UK.

Abstract

BACKGROUND:

Acute-phase proteins may help assess the nature and severity of lesions and outcome in horses undergoing colic surgery.

OBJECTIVES:

Compare serum amyloid A and plasma fibrinogen concentrations ([SAA] and [fibrinogen]) in the immediate post-operative period after exploratory celiotomy and determine their value in assessment of post-operative complications and survival to discharge.

STUDY DESIGN:

Observational study.

METHODS:

Included horses over one year old undergoing exploratory celiotomy. Surgical procedures, lesions, post-operative care, complications and survival to discharge were recorded. [SAA] and [fibrinogen] were measured prior to surgery, and 5 days post-operatively. Statistical analyses included Yate's chi-square test, linear mixed effect model, Mann-Whitney U test and logistic regression.

RESULTS:

Of 300 horses, 52.0% developed post-operative complications and 83.7% survived to discharge, with significantly reduced chance of survival in horses that developed post-operative complications (p<0.01). Median [SAA] at days 1, 2, 3, 4 and 5, and median [fibrinogen] at days 3, 4 and 5 were significantly different between horses that did and did not develop post-operative complications (p<0.05). Median [SAA] at days 1, 4 and 5 were significantly different between horses that did and did not survive to discharge (p<0.05). Logistic regression revealed post-operative complications to be associated with strangulating lesions (OR 2.35, 95%CI 1.41-3.91, p≤0.001) and higher [fibrinogen] at admission (OR 1.21, 95%CI 1.00-1.45, p<0.05), and survival to discharge to be associated with lower [SAA] at 5 days post-operatively (OR 0.965, 95%CI 0.94-0.99, p = 0.002).

MAIN LIMITATIONS:

Large variety of lesions and complications prevented detailed analysis of associations between inflammatory markers, lesions and complications.

CONCLUSIONS:

Horses that develop post-operative complications have acute-phase responses of greater magnitudes and durations compared to those that do not develop complications. This is also seen in horses that do not survive to discharge. Measuring [SAA] daily and [fibrinogen] at admission, may help predict development of post-operative complications. This article is protected by copyright. All rights reserved.

KEYWORDS:

colic, serum amyloid A; horse; plasma fibrinogen; post-operative complications

PMID:
30912857
DOI:
10.1111/evj.13117

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