Evaluation of peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity for detection of septic peritonitis in horses

OBJECTIVE: To determine whether peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity can be used to differentiate horses with septic peritonitis from those with nonseptic peritonitis. DESIGN: Prospective study. ANIMALS: 46 horses, including 10 healthy horses, 15 horses with septic peritonitis, and 21 horses with nonseptic peritonitis. PROCEDURE: Peritoneal fluid and blood samples were analyzed for pH, glucose concentration, and lactate dehydrogenase activity. Complete blood cell counts were performed, and peritoneal fluid samples were submitted for bacterial culture. RESULTS: Horses with septic peritonitis had significantly lower peritoneal fluid pH and glucose concentrations than horses with nonseptic peritonitis and healthy horses. Compared with other tests, serum-to-peritoneal fluid glucose concentration differences > 50 mg/dl had the highest diagnostic use for detection of septic peritonitis. Peritoneal fluid pH < 7.3, glucose concentration < 30 mg/dl, and fibrinogen concentration > 200 mg/dl were also highly indicative of septic peritonitis. CLINICAL IMPLICATIONS: Peritoneal fluid pH and glucose concentration can be used to assist in the identification of horses with septic peritonitis. These measurements can provide an early indication of sepsis, especially if cytologic evaluation of peritoneal fluid is unavailable or results are equivocal and peritoneal fluid bacterial culture results are pending.     

Body position and mode of ventilation influences arterial pH, oxygen, and carbon dioxide tensions in halothane-anesthetized horses.

Effects of body position and type of ventilation were determined on arterial blood gases (PaO2, PaCO2) and pH during and immediately following clinical halothane anesthesia in 36 young, physically conditioned horses. Horses in dorsal recumbency had a lower PaO2 than did similarly breathing horses in a lateral position. Predictably controlled positive-pressure ventilation inproved arterial oxygenation and permitted maintenance of a normal PaCO2. Most horses, regardless of type of ventilation and operative body positioning, were hypoxemic in the immediate postanesthetic period.     

Comparison of peritoneal fluid and peripheral blood pH,bicarbonate, glucose,and lactate concentration as a diagnostic tool for septic peritonitis in dogs and cats

OBJECTIVE: To establish a reliable diagnostic tool for septic peritonitis in dogs and cats using pH, bicarbonate, lactate, and glucose concentrations in peritoneal fluid and venous blood. STUDY DESIGN: Prospective clinical study. ANIMALS: Eighteen dogs and 12 cats with peritoneal effusion. METHODS: pH, bicarbonate, electrolyte, lactate, and glucose concentrations were measured on 1- to 2-mL samples of venous blood and peritoneal fluid collected at admission. The concentration difference between blood and peritoneal fluid for pH, bicarbonate, glucose, and lactate concentrations were calculated by subtracting the peritoneal fluid concentration from the blood concentration. Peritoneal fluid was submitted for cytologic examination and bacterial culture. Peritonitis was classified as septic or nonseptic based on cytology and bacterial culture results. RESULTS: In dogs, with septic effusion, peritoneal fluid glucose concentration was always lower than the blood glucose concentration. A blood-to-fluid glucose (BFG) difference > 20 mg/dL was 100% sensitive and 100% specific for the diagnosis of septic peritoneal effusion in dogs. In 7 dogs in which it was evaluated, a blood-to-fluid lactate (BFL) difference < -2.0 mmol/L was also 100% sensitive and specific for a diagnosis of septic peritoneal effusion. In cats, the BFG difference was 86% sensitive and 100% specific for a diagnosis of septic peritonitis. In dogs and cats, the BFG difference was more accurate for a diagnosis of septic peritonitis than peritoneal fluid glucose concentration alone. CONCLUSIONS: A concentration difference > 20 mg/dL between blood and peritoneal fluid glucose concentration provides a rapid and reliable means to differentiate a septic peritoneal effusion from a nonseptic peritoneal effusion in dogs and cats. CLINICAL RELEVANCE: The difference between blood and peritoneal fluid glucose concentrations should be used as a more reliable diagnostic indicator of septic peritoneal effusion than peritoneal fluid glucose concentration alone.     

Calculation of bovine haemoglobin oxygen saturation by algorithms integrating age,haemoglobin content,blood pH,partial pressures of oxygen and carbon dioxide in the blood,and temperature

In human and veterinary medicine, arterial and venous haemoglobin oxygen saturations are often used to estimate the severity of a disease and to guide therapeutic decisions. In veterinary medicine, haemoglobin oxygen saturation (SO(2)) is usually calculated using a blood gas analyser and algorithms developed for humans. It is possible, therefore, that the values obtained in animals may be distorted, particularly in animals with a high haemoglobin oxygen affinity, like young calves. In order to verify this hypothesis, we compared the arterial (SaO(2)) and venous (SvO(2)) haemoglobin oxygen saturations calculated using three different algorithms, and the oxygen exchange fraction (OEF) at the tissue level, which is the degree of haemoglobin desaturation between arterial and venous blood (SaO(2)-SvO(2)), with the values obtained from the whole bovine oxygen equilibrium curve (OEC) determined by a reference method. The blood gas analysers underestimated SvO(2) values; consequently, the OEF was overestimated (by about 10%). Two methods of reducing these errors were assessed. As the haemoglobin oxygen affinity decreases during the first month of life in calves a relationship between PO(2) at 50% haemoglobin saturation (P50) and age was established in order to correct the calculated values of venous and arterial SO(2), taking into account the estimated position of the OEC. This method markedly reduced the error for SvO(2) and OEF. Secondly, the SO(2) was calculated using a mathematical model taking into account the age of the animal and the specific effects of pH, PCO(2), and temperature on the bovine OEC. Using this method, the mean difference between the OEF values calculated using the mathematical model and those calculated by the reference method was close to zero. The errors produced by blood gas analysers can thus be minimised in two ways: firstly, by simply introducing a P50 estimated from the age of the calf into the analyser before the measurement; and secondly, by calculating the SO(2) using a mathematical model applied to the bovine OEC.     

Effect of nasogastric administration of sodium bicarbonate on carbon 13 isotopic enrichment of carbon dioxide in serum of horses

OBJECTIVE: To determine the effect of administration of commercially available sodium bicarbonate (NaHCO3) on carbon 13 (13C) isotopic enrichment of carbon dioxide (CO2) in serum of horses. ANIMALS: 7 healthy Thoroughbreds. PROCEDURES: Sodium bicarbonate (450 g) was administered via nasogastric intubation to horses. Horses had been fed a diet obtained from the same source and had access to water from the same source for 3 months before the study. Blood samples were collected immediately before and at 2, 4, 6, and 24 hours after administration of NaHCO3. The concentration of total CO2 in serum was measured by use of a commercial analyzer. The 13C enrichment of bicarbonate in serum was estimated by measurement of 13C enrichment of CO2 released by acidification of the serum. The 13C enrichment of commercially available NaHCO3 was also determined and compared with that of CO2 in serum of horses before administration of NaHCO3. RESULTS: Commercially available NaHCO3 had a 13C enrichment significantly different from that of carbon dioxide in serum of horses before treatment. Administration of NaHCO3 increased the concentration of total CO2 from pretreatment values. The 13C enrichment of CO2 in serum was only transiently and minimally affected after administration of NaHCO3. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of NaHCO3 was not detected by measuring 13C enrichment of CO2 in serum of horses.     

Cardiopulmonary,blood and peritoneal fluid alterations associated with abdominal insufflation of carbon dioxide in standing horses

REASONS FOR PERFORMING STUDY: Abdominal insufflation is performed routinely during laparoscopy in horses to improve visualisation and facilitate instrument and visceral manipulations during surgery. It has been shown that high-pressure pneumoperitoneum with carbon dioxide (CO2) has deleterious cardiopulmonary effects in dorsally recumbent, mechanically ventilated, halothane-anaesthetised horses. There is no information on the effects of CO2 pneumoperitoneum on cardiopulmonary function and haematology, plasma chemistry and peritoneal fluid (PF) variables in standing sedated horses during laparoscopic surgery. OBJECTIVES: To determine the effects of high pressure CO2 pneumoperitoneum in standing sedated horses on cardiopulmonary function, blood gas, haematology, plasma chemistry and PF variables. METHODS: Six healthy, mature horses were sedated with an i.v. bolus of detomidine (0.02 mg/kg bwt) and butorphanol (0.02 mg/kg bwt) and instrumented to determine the changes in cardiopulmonary function, haematology, serum chemistry and PF values during and after pneumoperitoneum with CO2 to 15 mmHg pressure for standing laparoscopy. Each horse was assigned at random to either a standing left flank exploratory laparoscopy (LFL) with CO2 pneumoperitoneum or sham procedure (SLFL) without insufflation, and instrumented for measurement of cardiopulmonary variables. Each horse underwent a second procedure in crossover fashion one month later so that all 6 horses had both an LFL and SLFL performed. Cardiopulmonary variables and blood gas analyses were obtained 5 mins after sedation and every 15 mins during 60 mins baseline (BL), insufflation (15 mmHg) and desufflation. Haematology, serum chemistry analysis and PF analysis were performed at BL, insufflation and desufflation, and 24 h after the conclusion of each procedure. RESULTS: Significant decreases in heart rate, cardiac output and cardiac index and significant increases in mean right atrial pressure, systemic vascular resistance and pulmonary vascular resistance were recorded immediately after and during sedation in both groups of horses. Pneumoperitoneum with CO2 at 15 mmHg had no significant effect on cardiopulmonary function during surgery. There were no significant differences in blood gas, haematology or plasma chemistry values within or between groups at any time interval during the study. There was a significant increase in the PF total nucleated cell count 24 h following LFL compared to baseline values for LFL or SLFL at 24 h. There were no differences in PF protein concentrations within or between groups at any time interval. CONCLUSIONS: Pneumoperitoneum with CO2 during standing laparoscopy in healthy horses does not cause adverse alterations in cardiopulmonary, haematology or plasma chemistry variables, but does induce a mild inflammatory response within the peritoneal cavity. POTENTIAL RELEVANCE: High pressure (15 mmHg) pneumoperitoneum in standing sedated mature horses for laparoscopic surgery can be performed safely without any short-term or cumulative adverse effects on haemodynamic or cardiopulmonary function.     

Determination of lactate concentrations in blood plasma and peritoneal fluid in horses with colic by an Accusport analyzer

BACKGROUND: Intestinal hypoperfusion can lead to increased lactate concentrations in plasma and peritoneal fluid of horses with colic. HYPOTHESIS: The purposes of this study were to (1) evaluate the reliability of the Accusport analyzer to assess peritoneal fluid lactate (PFL) concentrations in healthy horses and those with colic, (2) identify clinical features associated with abnormal blood plasma lactate (BPL) and PFL concentrations, and (3) evaluate the prognostic value of BPL and PFL. ANIMALS: BPL and PFL were determined in 20 healthy horses and in 106 horses with colic. RESULTS: The Accusport was reliable for determining BPL concentrations < 13 mM and PFL concentrations < 20 mM. Multivariate analysis indicated that PCV and the need for intestinal resection were independently associated with the BPL; pulse, PCV, venous pO2, the presence of necrotic intestine, an increased amount of peritoneal fluid, and fluid total protein content were independently associated with PFL. With a 1 mM increase in BPL or PFL, the respective odds ratios for required abdominal surgery increase to 1.23 (BPL) and 1.58 (PFL), odds ratios for a required intestinal resection increase to 1.20 (BPL) and 1.41 (PFL), and odds ratios for developing ileus increase by 1.33 (BPL) and 1.36 (PFL). PFL concentrations of 1, 6, 12, and 16 mM correspond to a probability of death of 11, 29, 63, and 82%, respectively, in horses without strangulating obstruction and of 25, 52, 82, and 92%, respectively, in horses with strangulating obstruction. CONCLUSION: PFL is more useful and sensitive than BPL for prognostic purposes in horses with colic.     

Blood lipid, glucose, and insulin concentrations in Morgan horses and Thoroughbreds

Insulin resistance has been detected in obese Morgan horses and it has been suggested that horses of this breed are predisposed to this condition. The objective of this study was to determine whether blood lipid, glucose, and insulin concentrations differed between Morgan horses and Thoroughbreds housed at the same facility. Fourteen Morgan horses (five mares, nine geldings) ranging in age from 4 to 14 years were compared with 21 Thoroughbreds (11 mares, 10 geldings; age range 7–20 years) from the same herd. A single blood sample was collected from each horse after grain was withheld overnight. Variables were compared between breed groups and breed-specific reference ranges were calculated. Triglyceride, cholesterol, nonesterified fatty acid, glucose, and insulin concentrations did not differ between breeds of horse in this study. This may be because horses included in this study did not suffer from obesity and were regularly exercised.     

Growth hormone secretion in relation to plasma lactate and glucose concentrations during a maximal treadmill exercise test in horses

Veterinary Research Communications -     

Maximal lactate concentrations in horses after exercise of different duration and intensity

Lactate kinetics in whole blood of horses was investigated after exercise of differing velocities and duration. The following categories of exercise were used: A: <11 m/second and >180 seconds (n=35), B: >11 m/second and <180 seconds (n=17) and C: <11 m/second and <180 s (n=10). The mean peak lactate concentration determined in horses in category A was 4.49 ± 2.21 mmol/1, in B, 16.32 ± 4.81 mmoVl and in C, 4.58 ± 1.59 mmol/l. While the maximum lactate concentrations in categories A and C were always found immediately after the exercise, the peaks in category B were measured between the first and tenth minute after exercise. Mean lactate concentrations measured at 2-minute intervals after bouts of category-B exercise tended to stabilize 3 to 10 minutes after exercise; however, mean lactate concentrations measured during the intervals before and after the peak value differed significantly. The lactate concentration returned to pre-exercise levels within 20 minutes after exercise bouts of category C, but remained above pre-exercise levels up to 60 minutes after bouts of category-A and -B exercise. It was concluded that, for an evaluation of lactate data after intensive anaerobic exercise, sequential blood sampling at 2-minute intervals for a period of up to 12 minutes after exercise is necessary. Less frequent sampling may be a reason for the often described irreproducibility of lactate concentrations in horses. After aerobic or mild anaerobic exercise, one sample is sufficient, but it has to be taken as soon as possible after exercise.     

Effects of warm-up intensity on kinetics of oxygen consumption and carbon dioxide production during high-intensity exercise in horses

OBJECTIVE: To compare effects of low and high intensity warm-up exercise on oxygen consumption (VO2) and carbon dioxide production (VCO2) in horses. ANIMALS: 6 moderately conditioned adult Standard-breds. PROCEDURES: Horses ran for 2 minutes at 115% of maximum oxygen consumption (VO2max), 5 minutes after each of the following periods: no warm-up (NoWU); 10 minutes at 50% of VO2max (LoWU); or 7 minutes at 50% VO2max followed by 45-second intervals at 80, 90, and 100% VO2max (HiWU). Oxygen consumption and VCO2 were measured during exercise, and kinetics of VO2 and VCO2 were calculated. Accumulated O2 deficit was also calculated. RESULTS: For both warm-up trials, the time constant for the rapid exponential increase in VO2 was 30% lower than for NoWU. Similarly, the rate of increase in VCO2 was 23% faster in LoWU and HiWU than in NoWU. Peak values for VO2 achieved during the high-speed test were not significantly different among trials (LoWU, 150.2 +/- 3.2 ml/kg/min; HiWU, 151.2 +/- 4.2 ml/kg/min; NoWU, 145.1 +/- 4.1 ml/kg/min). However, accumulated O2 deficit (ml of O2 equivalents/kg) was significantly lower during LoWU (65.3 +/- 5.1) and HiWU (63.4 +/- 3.9) than during NoWU (82.1 +/- 7.3). CONCLUSIONS AND CLINICAL RELEVANCE: Both the low- and high-intensity warm-up, completed 5 minutes before the start of high-intensity exercise, accelerated the kinetics of VO2 and VCO2 and decreased accumulated O2 deficit during 2 minutes of intense exertion in horses that were moderately conditioned.     

Blood concentrations of amino acids, glucose and lactate during experimental swine dysentery

The aim of this study was to examine blood concentrations of amino acids, glucose and lactate in association with experimental swine dysentery. Ten pigs (approximately 23kg) were orally inoculated with Brachyspira hyodysenteriae. Eight animals developed muco-haemorrhagic diarrhoea with impaired general appearance, changes in white blood cell counts and increased levels of the acute phase protein Serum Amyolid A. Blood samples were taken before inoculation, during the incubation period, during clinical signs of dysentery and during recovery. Neither plasma glucose nor lactate concentrations changed during the course of swine dysentery, but the serum concentrations of gluconeogenic non-essential amino acids decreased during dysentery. This was mainly due to decreases in alanine, glutamine, serine and tyrosine. Lysine increased during dysentery and at the beginning of the recovery period, and leucine increased during recovery. Glutamine, alanine and tyrosine levels show negative correlations with the numbers of neutrophils and monocytes. In conclusion, swine dysentery altered the blood concentrations of amino acids, but not of glucose or lactate.     

Changes in pH of peritoneal fluid associated with carbon dioxide insufflation during laparoscopic surgery in dogs

OBJECTIVE: To evaluate changes in pH of peritoneal fluid associated with CO2 insufflation during laparoscopy in dogs. ANIMALS: 13 client-owned dogs and 10 purpose-bred teaching dogs. PROCEDURES: Laparotomy was performed on control dogs; peritoneal fluid pH was measured at time of incision of the abdominal cavity (time 0) and 30 minutes later. Laparoscopic insufflation with CO2 was performed and routine laparoscopic procedures conducted on the teaching dogs. Insufflation pressure was limited to 12 mm Hg. Intraperitoneal fluid pH was measured by use of pH indicator paper at 4 time points. Arterial blood gas analysis was performed at the same time points. RESULTS: Peritoneal fluid pH did not change significantly between 0 and 30 minutes in the control dogs. For dogs with CO2 insufflation, measurements obtained were a mean of 8.5, 24.5, 44.5, and 72.0 minutes after insufflation. The pH of peritoneal fluid decreased significantly between the first (7.825 +/- 0.350) and second (7.672 +/- 0.366) time point. Blood pH decreased significantly between the first (7.343 +/- 0.078), third (7.235 +/- 0.042), and fourth (7.225 +/- 0.038) time points. The PaCO2 increased significantly between the first (39.9 +/- 9.8 mm Hg) and fourth (54.6 +/- 4.4 mm Hg) time points. Base excess decreased significantly between the first and all subsequent time points. CONCLUSIONS AND CLINICAL RELEVANCE: Pneumoperitoneum attributable to CO2 insufflation caused a mild and transient decrease in peritoneal fluid pH in dogs. Changes in peritoneal fluid associated with CO2 insufflation in dogs were similar to those in other animals.     

Effects of dexamethasone,glucose infusion,adrenocorticotropin, and propylthiouracil on plasma leptin concentrations in horses

In experiment 1, nine light horse geldings (three 3 x 3 Latin squares) received dexamethasone (DEX; 125 microg/kg BW, i.m.), glucose (0.2 g/kg BW, i.v.), or nothing (control) once per day for 4 days. DEX increased (P < 0.001) glucose, insulin, and leptin concentrations and resulted in a delayed increase (P < 0.001) in IGF-I concentrations. In experiment 2, mares were similarly treated with DEX (n = 6) or vehicle (n = 6). DEX again increased (P < 0.01) glucose, insulin, and leptin concentrations; the delayed elevation in IGF-I concentrations occurred on day 10, 12, and 19, relative to the first day of treatment. In experiment 3, six light horse geldings received either 200 IU of adrenocorticotropin (ACTH) i.m. or vehicle twice daily for 4 days. ACTH increased (P < 0.001) cortisol concentrations. Further, ACTH resulted in increases (P < 0.01) glucose, insulin, and leptin concentrations. In experiment 4, plasma samples from four light horse stallions that were fed 6-n-propyl-2-thiouracil (PTU) at 6 mg/kg BW for 60 days to induce hypothyroidism were compared to samples from control stallions. On day 52, stallions receiving PTU had lower concentrations of thyroxine (P < 0.05) and triiodothyronine (P < 0.01) and higher (P < 0.01) concentrations of TSH. Leptin concentrations were higher (P < 0.01) in PTU-fed stallions from day 10 through 52. In conclusion, circulating concentrations of leptin in horses was increased by administering DEX. Treatment with ACTH increased cortisol and resulted in lesser increases in leptin, glucose, and insulin. In addition, PTU feeding results in lesser increases in leptin concentrations.     

Plasma potassium and lactate concentrations in thoroughbred horses during exercise of varying intensity.

To investigate the effect of moderate to high intensity exercise of up to 6 min duration on plasma potassium and lactate concentrations, 6 Thoroughbred horses were studied using a treadmill at a 5 degree incline. Each test consisted of an 8-min standardised warm-up followed by an exercise bout at 8, 9, 10 or 12 m/sec. The horses were galloped at each speed for up to a maximum of 6 min or until signs of fatigue were present. The horses were then walked at 0 degree incline. Carotid arterial blood samples were taken during and after the exercise. At 8, 9 and 10 m/sec there was a general pattern of an initial rise in potassium to a peak around 1.5 min of exercise with the concentration then slowly decreasing. At 12 m/sec there was a continuous rise to a peak at the end of exercise in all horses. Immediately after exercise there was a rapid return (within 3-4 min) to the potassium concentrations recorded at the end of the warm-up period. Plasma lactate peaked around the end of exercise at all speeds. At the highest intensity of exercise the mechanisms for the re-uptake of potassium did not appear to be able to match the rate of efflux. In contrast, at less intense work loads, the rate of re-uptake appeared to be similar to or slightly greater than the rate of efflux. It is possible that a disturbance in this balance between efflux and re-uptake could result in a disturbance in normal neuromuscular function during exercise.