Administration of Perioperative Penicillin Reduces Postoperative Serum Amyloid A Response in Horses Being Castrated Standing

Objectives: To compare postoperative inflammatory responses in horses administered perioperative procaine penicillin and those not administered penicillin using acute phase protein serum amyloid A (SAA) as a marker of inflammation. Study Design: Randomized clinical trial. Animals: Stallions (n=50) castrated under field conditions. Methods: SAA concentrations were determined on days 0, 3, and 8. Six horses were subsequently excluded because of elevated SAA concentrations on day 0. Of the remaining 50 horses, 26 were administered nonsteroidal anti‐inflammatory drug (NSAID) therapy and 24 were administered NSAID and 25,000 U/kg procaine penicillin on day 0, 1, and 2. Results: SAA concentrations increased significantly from preoperative levels in both groups, and on day 8 concentrations were significantly (P<.02) higher in horses administered only NSAID than in those administered procaine penicillin and NSAID. Infectious complications occurred more frequently (P<.01) in horses with preoperatively elevated SAA concentrations (the excluded horses) than in horses with normal preoperative SAA concentrations (the included horses). Conclusions: Perioperative antimicrobial therapy reduced the postoperative SAA response, suggesting that bacteria were present in the surgical wound and contributed to inflammation after castration. Horses with elevated preoperative SAA concentrations developed infectious complications more often than horses with normal preoperative SAA concentrations. Clinical Relevance: Administration of antimicrobials may be important in horses being castrated standing under field conditions. Increased SAA concentrations seem to be an indicator of increased surgical risk in horses and may be useful before elective surgery for planning.     

Acute Phase Response to Surgery of Varying Intensity in Horses: A Preliminary Study

Objective— To evaluate the postoperative inflammatory response of horses to elective surgery of varying intensity.
Study Design— Prospective longitudinal study.
Animals— Horses referred to 2 hospitals for either arthroscopic removal of a unilateral osteochondritic lesion in the tibiotarsal joint (minimal surgical trauma, n=11), correction of recurrent laryngeal neuropathy by laryngoplasty and ventriculectomy (intermediate surgical trauma, n=10) or removal of an ovarian tumor by laparotomy (major surgical trauma, n=5).
Methods— Horses had a thorough clinical examination every day. White blood cell (WBC) counts and concentrations of serum amyloid A (SAA), fibrinogen, and iron were assessed in blood samples obtained before, and 1–3, 5, 7, 9, and 11 days after surgery. Differences in levels of the inflammatory markers between the 3 surgical groups were analyzed using repeated measures ANOVA.
Results— Postoperative concentrations of SAA and fibrinogen were significantly higher in horses that had laparotomy and ovariectomy than in horses that had laryngoplasty and ventriculectomy, or arthroscopy. Iron concentrations decreased to lower levels after intermediate and major surgical trauma than after small surgical trauma. WBC count did not differ between the 3 groups.
Conclusions— Levels of SAA, fibrinogen, and iron reflected the intensity of the surgical trauma, whereas WBC count did not.
Clinical Relevance— Postoperative measurements of SAA, fibrinogen, and iron may be useful for comparing surgical trauma associated with new and established surgical techniques. Moreover, knowledge of the normal postoperative acute phase response is essential, if acute phase reactants are to be used for monitoring occurrence of postoperative infections.     

The acute phase response in calves experimentally infected with bovine viral diarrhoea virus and/or Mannheimia haemolytica

The aim of this investigation was to study differences and similarities in the acute phase response of calves experimentally infected in the respiratory tract with either bovine viral diarrhoea virus (BVDV) or Mannheima haemolytica (Mh), or with a combination of both (BVDV/Mh). A non-inoculated control group was also included. The acute phase response was measured by serum or plasma concentrations of the acute phase proteins (APPs) haptoglobin, serum amyloid A (SAA) and fibrinogen, and of cortisol, prostaglandin F2alpha-metabolite and interferon-alpha (IFN-alpha) activity. Clinical symptoms were also recorded and were most severe in the BVDV/Mh group. The symptoms were mild to moderate in the BVDV group, while none, or very mild symptoms were observed in the Mh group. In all inoculated groups, a significant acute phase response was observed, with elevated values of haptoglobin, SAA and fibrinogen, while the control group remained unaffected throughout the study. In general, the magnitude of the response was similar, but the duration of elevated concentrations of APPs was significantly longer in the BVDV/Mh group than in the BVDV group, reflecting the duration of the clinical symptoms. However, in the single infection groups, the APP response and the clinical symptoms were not correlated. The IFN-alpha activity increased in all BVDV-inoculated animals, but no response in cortisol and PGF2alpha-metabolite concentrations was observed after infection. Basal levels of serum concentrations of haptoglobin, SAA and fibrinogen were established and may be used for evaluating calf health in herds. The duration of elevated haptoglobin, SAA and fibrinogen values did not differ significantly within groups indicating that their value as indicator of disease is equal.     

Vaccination elicits a prominent acute phase response in horses

European and American guidelines for vaccination against tetanus and influenza in horses recommend annual and annual/semi-annual vaccinations, respectively, against the two pathogens. Too-frequent vaccination may, however, have adverse effects, among other things because an inflammatory response is elicited with subsequent alterations in homeostasis. The objective of the study was to compare the acute phase response (APR) in 10 horses following administration of two different types of vaccines, namely, an inactivated Immune Stimulating COMplex (ISCOM) vaccine and a live recombinant vector vaccine. Blood was sampled before and after vaccination to measure levels of serum amyloid A (SAA), fibrinogen, white blood cell counts (WBC) and iron. Vaccination induced a prominent APR with increased WBC, elevated blood levels of SAA and fibrinogen, and decreased serum iron concentrations. The ISCOM vaccine caused significantly (P<0.05) greater SAA, fibrinogen and WBC responses than the vector vaccine. During the APR muscle catabolism and liver and kidney metabolism are altered. Also drug metabolism may change during the APR. The findings of the present study may be relevant for advising horse owners about convalescence after vaccination.     

Measurement of serum amyloid A in the neonatal foal using a latex agglutination immunoturbidimetric assay: determination of the normal range, variation with age and response to disease.

This paper describes the use of a latex agglutination assay to measure serum amyloid A (SAA) in the neonatal foal. The normal range and response to clinical disease was determined. This retrospective study evaluated SAA concentrations over the first 3 days postpartum of 226 Thoroughbred foals judged to be clinically healthy. The normal range for each day was determined; levels were found to be significantly highest on Day 2 (Day 1 vs. Day 2 P<0.0001). The 95th percentile for Days 1-3 was 27.1 mg/l. Clinical records of 133 foals, presented as first or second opinion cases, were evaluated. Foals were divided into 4 groups; septicaemia (S), focal infection (FI), failure of passive transfer (FPT) and noninfectious disease (NI). There was a statistically significant difference (P<0.0001) between SAA concentrations of control foals compared to Groups S and FI. There was no statistically significant difference between controls and Groups FPT and NI. When Group NI was compared to Groups S and FI, there was a statistically significant difference (P<0.0001). The authors suggest that SAA determined by this latex agglutination assay might be a helpful aid in the diagnosis of septicaemia and focal infection in neonatal foals; levels >100 mg/l are highly suggestive of infection in young foals.     

A non-competitive chemiluminescence enzyme immunoassay for the equine acute phase protein serum amyloid A (SAA) -- a clinically useful inflammatory marker in the horse.

A non-competitive chemiluminescence enzyme immunoassay for measuring serum amyloid A (SAA) in equine serum was developed. A polyclonal anti-equine-amyloid A antiserum specific for equine SAA was utilized, and the assay was standardized using highly purified equine SAA. An acute phase horse serum was calibrated against the purified SAA and was used as standard when running the assay. Serum SAA concentrations in the range of 3-1210 mg/l could be measured. The reference range of SAA in clinically healthy adult horses was <7 mg/l. The clinical validation of the assay comprised the SAA responses after surgery and experimentally induced aseptic arthritis, and those associated with viral and bacterial infections. The SAA response after surgery (castration) was consistent, with peak concentrations on day 2 and a return to normal SAA concentrations within eight days. The aseptic arthritis produced an SAA response with a pattern similar to that seen after surgery, with peak concentrations of SAA 36-48 h after induction. Seven horses showed a biphasic pattern, with a second rise in SAA concentrations on day 4 and 5. All animals had SAA levels <7 mg/l on day 15. All horses with viral and bacterial infections had SAA concentrations above 7 mg/l. The ranges of SAA concentrations following the different types of inflammation overlap, being consistent with the unspecific nature of the SAA response. This study revealed that SAA is a sensitive and unspecific marker for inflammation, and describes the dynamics of the SAA response after standardized and well defined tissue damage.     

Acute phase protein response in dogs with experimentally induced gastric mucosal injury

Background: The acute phase response is part of the innate defense system of an animal against trauma, inflammation, and infection. Objective: The purpose of this investigation was to evaluate the acute phase response in dogs with acetylsalicylic acid-induced gastric mucosal injuries and to determine its potential diagnostic significance. Methods: Ten, healthy, cross-breed dogs (6 females and 4 males) were given oral acetylsalicylic acid in a single oral dose of 200 mg/kg for the experimental model of acute gastric mucosal injury. Heparinized blood samples were collected before (day 0) and on days 1, 4, and 7 after acetylsalicylic acid administration to determine plasma C-reactive protein (CRP), serum amyloid-A (SAA), haptoglobin, fibrinogen, total protein, albumin, and iron concentrations. Total WBC counts were done in whole blood. Endoscopy was done on each of the selected days, and gastric lesions were scored and localized. Results: Hemorrhagic linear erosions were found in all dogs on day 1, concurrent with significant increases in CRP, SAA, haptoglobin, and fibrinogen concentrations, and in WBC counts; however, iron concentration was decreased. Peak haptoglobin and fibrinogen concentrations occurred on day 4, at which time only nonhemorrhagic lesions were observed endoscopically. On day 7, results for all analytes except haptoglobin had returned to baseline levels, along with resolution of most gastric lesions. Conclusions: Results of this study indicate that a rapid acute phase protein response occurs after induced gastric mucosal injury in dogs and may be potentially useful together with gastroscopy in the diagnosis and monitoring of gastric injury.     

Evaluation of ‘Section‐Ligation‐Release (SLR)’ Technique Devised for Castration in the Stallion

A novel technique [Section‐Ligation‐Release (SLR)] was evaluated for castration in the horse. Clinical traits, serum testosterone concentrations after challenge with human chorionic gonadotrophin (hCG), and histopathological changes of the testicular tissue were assessed. Five stallions, aged 24–48 months, were castrated using SLR technique under general anaesthesia. Both spermatic cords in each stallion were exposed at the scrotal neck by two 5‐cm long incisions, followed by sharp dissection through the parietal vaginal tunic. Both vascular and non‐vascular structures in the cords were triple clamped, transected and ligated. Both testes were left in situ. Serum testosterone concentrations were measured pre‐operatively and at 2 months after castration following IV administration of 1 × 10⁴ IU of hCG. Both testes from each castrate were collected at 2 months for histopathologic examination. SLR castration was successfully achieved. Moderated scrotal and preputial swelling was the only experienced short‐term complication. Serum testosterone concentrations were significantly lower than basal pre‐operative levels at 2 months after castration, and did not respond to hCG. On histopathology, hyalinization of the seminiferous tubules and loss of testicular interstitial tissue were indicative of complete avascular necrosis. This novel primary closure castration technique of stallion is a simple practical method, with minimal post‐operative complications; and could be safely advocated as an alternative to the traditional castration techniques allowing for second intention healing of scrotal wounds.     

Use of serum amyloid A in equine medicine and surgery

Serum amyloid A (SAA) has become an indispensable part of the management of equine patients in general practice and specialized hospital settings. Although several proteins possess acute phase properties in horses, the usefulness of SAA exceeds that of other acute phase proteins. This is due to the highly desirable kinetics of the equine SAA response. SAA concentrations exhibit a rapid and pronounced increase in response to inflammation and a rapid decline after the resolution of inflammation. This facilitates the detection of inflammatory disease and real-time monitoring of inflammatory activity. SAA may be used in all stages of patient management: (1) before diagnosis (to rule in/rule out inflammatory disease), (2) at the time of diagnosis (to assess the severity of inflammation and assist in prognostication), and (3) after diagnosis (to monitor changes in inflammatory activity in response to therapy, with relapse of disease, or with infectious/inflammatory complications). By assessing other acute phase reactants in addition to SAA, clinicians can succinctly stage inflammation. White blood cell counts and serum iron concentration change within hours of an inflammatory insult, SAA within a day, and fibrinogen within 2–3 days; the interrelationship of these markers thus indicates the duration and activity of the inflammatory condition. Much research on the equine SAA response and clinical use has been conducted in the last decade. This is the prerequisite for the evidence-based use of this analyte. However, still today, most published studies involve a fairly low number of horses. To obtain solid evidence for use of SAA, future studies should be designed with larger sample sizes.     

Acute exercise does not induce an acute phase response (APR) in Standardbred trotters

The purpose of the study was to investigate whether acute strenuous exercise (1600- to 2500-m race) would elicit an acute phase response (APR) in Standardbred trotters. Blood levels of several inflammatory markers [serum amyloid A (SAA), haptoglobin, fibrinogen, white blood cell count (WBC), and iron], muscle enzymes [creatinine kinase (CK) and aspartate transaminase (AST)], and hemoglobin were assessed in 58 Standardbred trotters before and after racing. Hemoglobin levels increased and iron levels decreased 12 to 14 h after racing and haptoglobin concentrations, white blood cell counts, and iron levels were decreased 2 and/or 7 d after racing. Concentrations of CK, AST, SAA, and fibrinogen were unaltered in response to racing.Acute strenuous exercise did not elicit an acute phase reaction. The observed acute increase in hemoglobin levels and decreases in haptoglobin and iron levels may have been caused by exercise-induced hemolysis, which indicates that horses might experience a condition similar to athlete’s anemia in humans. The pathogenesis and clinical implications of the hematological and blood-biochemical changes elicited by acute exercise in Standardbred trotters in the present study warrant further investigation.     

Evaluation of a commercially available human serum amyloid A (SAA) turbidometric immunoassay for determination of equine SAA concentrations

The aim of the present study was to evaluate whether equine serum amyloid A (SAA) concentrations could be measured reliably with a turbidometric immunoassay (TIA) developed for use with human serum. Intra- and inter-assay imprecision were evaluated by multiple measurements on equine serum pools. Assay inaccuracy was determined by linearity under dilution. The assay was subsequently used for measuring SAA concentrations in clinically healthy horses, horses with inflammatory diseases, horses with non-inflammatory diseases, and in horses before and after castration. In pools with low, intermediate and high SAA concentrations, the intra-assay imprecisions were 24.4%, 1.6% and 2.1%, and the inter-assay imprecisions were 33.2%, 4.6% and 6.5%. Slight signs of inaccuracy were observed, but these inaccuracies were negligible when considering the large dynamic range of the SAA response. The assay was able to detect the expected difference in SAA levels in different groups of horses. It was also able to demonstrate the expected dynamic changes in SAA after castration. In conclusion, equine SAA concentrations can be measured reliably using the TIA designed for human SAA.     

Acute phase protein levels in pregnancy and oestrus cycle in bitches

The purpose of this study was to evaluate the acute phase protein (serum amyloid A, C-reactive protein, haptoglobin, ceruloplasmin and fibrinogen) profiles in pregnant dogs as well as bitches at various stages of the estrus cycle and to verify possible relationship(s) among the APPs profile and hormonal status. A total of 60 bitches of various breeds were enrolled. The animals were divided into six groups. B-mode ultrasonographic scanner (concept M/C) was used for pregnancy diagnosis, involving the first and second halves of pregnancy. Proestrus, estrus, diestrus and anestrus stages of sexual cycles were differentiated by use of vaginal cytology and blood progesterone and estradiol 17-β levels. Serum C-reactive protein (CRP), serum amyloid A (SAA), haptoglobin, ceruloplasmin and fibrinogen levels were determined. No statistically significant differences were observed between the groups with regard to the serum SAA and CRP concentrations. Haptoglobin, ceruloplasmin and fibrinogen concentrations were elevated in pregnant dogs compared to non-pregnant groups’, independently from the pregnancy stage. No statistically significant differences in acute phase protein concentrations in dogs at various stages of estrus could be detected. Results of this study indicated that ceruloplasmin and fibrinogen levels may have potential importance in the diagnosis of pregnancy, and acute phase proteins may be used for monitoring the health status of the pregnant dogs.     

Analgesic effect of butorphanol in ponies following castration

Reasons for performing study: In the UK butorphanol has a marketing authorisation for administration to horses for sedation in combination with detomidine, and at a higher dose (0.1 mg/kg bwt), for the alleviation of pain. There is only a limited number of clinical studies designed to examine the analgesic effects of butorphanol administration following surgery. Objective: To investigate the effect of premedication with butorphanol on post operative pain following castration under general anaesthesia in ponies. Hypothesis: Ponies receiving butorphanol would experience less pain after castration than ponies that did not receive butorphanol. Methods: A randomised, observer blinded clinical study in which 20 ponies received butorphanol and detomidine (Group B) or detomidine alone (Group C). Anaesthesia was induced with ketamine and diazepam and open castration performed. Pain was assessed by one individual using a dynamic interactive visual analogue scale (DIVAS) 100 mm in length (0 = no pain, 100 mm the maximum possible pain for that procedure). ‘Rescue’ analgesia was administered when DIVAS >50 mm and was butorphanol i.v. On the second occasion DIVAS was >50 mm, flunixin was administered i.v. Data from the DIVAS were analysed using a Mann Whitney Test. Results: Only one animal did not require rescue analgesia after surgery (Group C). DIVAS were not significantly different between groups (P = 0.063). Conclusions and potential relevance: Castration is sufficiently painful that administration of a single preoperative dose of butorphanol does not provide adequate post operative analgesia.     

Acute phase proteins as indicators of calf herd health

The potential for using acute phase proteins (APPs) in the assessment of herd health was studied by examining the levels of serum haptoglobin, serum amyloid A (SAA) and plasma fibrinogen in relation to clinical findings and leukocyte counts in calves. Two groups of calves from conventional dairy farms were studied. The animals were examined 10 times during the first six weeks after introduction into a new environment. Haptoglobin, SAA and fibrinogen were analysed and weight gain, disease symptoms and treatments were recorded. Analysis of antibodies against viral infections was performed. An acute phase reaction (APR) score was established at each sampling by combining the APP results and total leukocyte counts. The health status differed between the two groups, although no manipulation of health had been performed, except that the group with a higher incidence of disease had a concurrent experimental infection with lungworm as part of another study. In the group with a higher incidence of disease, the mean weight gain was significantly lower, and the number of sampling days with elevated serum concentrations of APPs, and the mean maximum concentrations of haptoglobin and fibrinogen were significantly higher compared to the healthier group. The APR score was significantly higher at days 4 and 8 of the study in the group with a higher incidence of disease. The results indicate that measurement of APPs could be a useful tool for evaluation of health in calf herds.     

Acute phase proteins in response to Dictyocaulus viviparus infection in calves

Three experiments were carried out to examine the acute phase response, as measured by the acute phase proteins (APP) haptoglobin, serum amyloid A (SAA) and fibrinogen, in calves infected with lungworm, Dictyocaulus vivparus. In addition, eosinophil counts were analysed. Three different dose models were used in 3 separate experiments: 1) 250 D. viviparus infective third stage larvae (L3) once daily for 2 consecutive days, II) 100 D. viviparus L3 once daily for 5 consecutive days, and III) 2000 L3 once. All 3 dose regimes induced elevated levels of haptoglobin, SAA and fibrinogen, although there was considerable variation both between and within experiments. A significant increase was observed in all 3 APP at one or several time points in experiment I and III, whereas in experiment II, the only significant elevation was observed for fibrinogen at one occasion. The eosinophil numbers were significantly elevated in all 3 experiments. The results show that lungworm infection can induce an acute phase response, which can be monitored by the selected APP. Elevated APP levels in combination with high numbers of eosinophils in an animal with respiratory disease may be used as an indicator of lung worm infection, and help the clinician to decide on treatment. However, high numbers of eosinophils and low levels of APP do not exclude a diagnosis of lungworm. Thus, lungworm infection may not be detected if measurements of APP are used to assess calf health in herds or individual animals.     

Racing performance following the laryngeal tie-forward procedure: a case-controlled study

REASONS FOR PERFORMING STUDY: The laryngeal tie-forward procedure (LTFP) is becoming widely used for correction of dorsal displacement of the soft palate (DDSP) despite the absence of an evidence-based assessment of its efficacy. HYPOTHESES: The LTFP returns racing performance to preoperative baseline levels and to that of matched controls; and post operative laryngohyoid position is associated with post operative performance. DESIGN AND POPULATION: Case-controlled study of racehorses undergoing a LTFP for dorsal displacement of the soft palate at Cornell University between October 2002 and June 2007. METHODS: The presence of at least one post operative start and race earnings ($) were used as outcome variables. Controls were matched by age, breed and sex from the third race prior to surgery. A novel radiographic reference system was used to determine laryngohyoid position pre- and post operatively. Data for definitively and presumptively diagnosed cases were analysed separately. RESULTS: During the study interval, 263 racehorses presented, of which 106 were included in the study; 36 had a definitive diagnosis of DDSP and 70 a presumptive diagnosis. Treated horses were equally likely to race post operatively as controls in the equivalent race. Treated horses had significantly lower earnings in the race before surgery than matched controls. The procedure moved the basihyoid bone dorsally and caudally and the larynx dorsally and rostrally. A more dorsal post operative basihyoid position and more dorsal and less rostral laryngeal position were associated with an increased probability of racing post operatively. CONCLUSIONS: Horses undergoing a LTFP are as likely to race post operatively as matched controls. The procedure restores race earnings to preoperative baseline levels and to those of matched controls. POTENTIAL RELEVANCE: This study provides strong evidence supporting the use of the LTFP in racehorses. Further work is needed to determine the relationship between laryngohyoid conformation and nasopharyngeal stability in horses.     

Two Regimes of Perioperative Antimicrobial Prophylaxis for Equine Castration: Clinical Findings,Acute-Phase Proteins,and Bacterial Cultures

A perioperative antibiotic for equine castration with second intention healing is controversial because the necessity is unclear and antimicrobial use promotes the selection of resistant bacteria. Information about different regimes for perioperative antimicrobial prophylaxis in equine castration is sparse. Goal of this study was to compare clinical findings, acute-phase proteins, and bacterial cultures in horses undergoing castration, treated with an intravenous single administration of penicillin G sodium (1× Pen group) or a 3-day course of daily intramuscular procaine penicillin (3× Pen group). Forty-eight stallions were castrated under general anesthesia using a closed technique, with second intention healing. Serum amyloid A (SAA) and fibrinogen were measured on days 0, 3, and 8. Body temperature, wound swelling, and drainage were recorded daily over 10 days. Bacterial swabs of the wound were taken on days 0 and 3. Scrotal swelling (P = .032), amount of drainage from the wound (P = .039), and body temperature (P = .013) on day 8 after castration were significantly higher in the 1× Pen group. The concentration of SAA and fibrinogen on day 8 was significantly higher in the 1× Pen group compared with the 3× Pen group (SAA: P = .049; fibrinogen: P = .035). β-Hemolytic Streptococcus spp. were found more frequently cultured in the 1× Pen group than in the 3× Pen group. Clinical and laboratory data indicate lower inflammatory reaction in the early postoperative period after three applications of penicillin compared with a single-administration. Further investigations evaluating the long-term outcome and potential development of antimicrobial resistant bacteria are needed.     

Nutritional and clinicopathological effects of post operative parenteral nutrition following small intestinal resection and anastomosis in the mature horse

REASONS FOR PERFORMING STUDY: There is an absence of data describing the nutritional requirements and nutritional status of horses following surgery for colic; furthermore, the potential effect of parenteral nutrition (PN) on improving nutritional status in such cases is unknown. HYPOTHESIS: Post operative colic cases suffer from a potentially detrimental negative energy balance and the PN formulation developed in this study would lead to clinicopathologically detectable improvements in the subjects' nutritional status. METHODS: Several clinicopathological variables, some known to be associated with nutritional status, were compared in 2 groups of horses in the post operative period following colic surgery; Group N (n = 15) were treated with PN and Group C (n = 15) were starved routinely. RESULTS: Group N had significantly lower serum concentrations of triglycerides, total bilirubin, albumin and urea and significantly higher serum concentrations of glucose and insulin compared with Group C in the post operative period. CONCLUSIONS: The control group of horses demonstrated significant clinicopathological evidence of starvation and the described PN protocol resulted in a demonstrably improved nutritional status in the treated horses. POTENTIAL RELEVANCE: Further study is required to investigate clinical benefits and possible harmful side effects of post operative parenteral nutrition before the technique can be advocated for widespread use in practice.     

Dynamics in serum of the inflammatory markers serum amyloid A (SAA), haptoglobin,fibrinogen and alpha2-globulins during induced noninfectious arthritis in the horse

Despite the importance of noninfectious joint diseases in equine medicine, little is known about the acute phase response which may be elicited if the local inflammatory process of noninfectious arthritis is sufficiently strong, Therefore the aim of this study was to monitor the systemic inflammatory response during experimentally-induced noninfectious arthritis by studying the dynamics in serum of the acute phase proteins serum amyloid A (SAA), haptoglobin, fibrinogen and alpha2-globulins. Twenty-four Standardbred horses, age 3-7 years, found healthy on thorough clinical, radiological, haematological and serum biochemical examination, were injected aseptically into the right midcarpal joint with amphotericin B. Blood samples were drawn before induction of arthritis (0 h), and at 8, 16, 24, 36 and 48 h postinduction and then on Days 3, 4, 5 and 15 postinduction. All horses developed lameness with joint effusion and joint heat as well as increased respiratory rate, heart rate and body temperature. The lameness started to decline after 24-36 h and, in most animals, systemic signs disappeared on Day 2 postinjection. The concentration of the acute phase proteins increased following induction of arthritis. The SAA concentrations were higher than baseline concentrations from 16 h postinduction and were maximal at 36-48 h (227 times baseline concentration). The haptoglobin concentrations were higher than baseline concentrations from 24 h and were maximal at 48-96 h (1.14 times baseline concentration). The maximal concentrations of fibrinogen were seen between 36-72 h postinjection and increased on average 0.87 times from baseline concentrations. The fibrinogen concentrations were higher than baseline concentrations from 24 h postinjection. Alpha2-globulins concentrations showed a minor increase and increased 0.55 times from baseline concentrations. The markers had returned to baseline concentrations by Day 15. Our results demonstrate that amphotericin B-induced arthritis in a single joint gives rise to a systemic acute phase response measurable as increased concentrations in serum SAA, haptoglobin, fibrinogen and alpha2-globulins during the first 2 weeks of the condition and, thereby, that such an increase need not be indicative of infectious arthritis. Further research should be aimed at determining whether chronic noninfectious arthritis in the horse gives rise to increased acute phase protein concentrations in serum.     

Serum iron and plasma fibrinogen concentrations as indicators of systemic inflammatory diseases in horses

BACKGROUND: Detection of systemic inflammation, which is important for proper diagnosis and prompt treatment, can be challenging. HYPOTHESIS: Measurement of plasma iron concentration is a sensitive method for detecting systemic inflammation in horses compared with measurements of plasma fibrinogen concentration, a traditional marker for inflammation in the horse. ANIMALS: Ninety-seven horses hospitalized with diseases causing systemic inflammation, 22 horses with localized inflammation, and 12 clinically normal horses were included in this study. METHODS: A retrospective study was made on hospitalized horses that had both plasma iron and fibrinogen concentrations measured on hospital admission. RESULTS: Plasma iron concentration was lower in horses with systemic inflammation (64 +/- 45 microg/dL) than the reference interval minimum (105 microg/dL) and were significantly lower (P = .001) than the value in a group of horses with local inflammation (123 +/- 45 microg/dL) and in healthy transported horses (143 +/- 29 microg/dL). Low plasma iron and high fibrinogen concentrations were both sensitive indicators of systemic inflammation in horses with sensitivity of 90 and 82%, respectively. There was a similar correlation between either continued decreases in iron concentration (Rsp of 0.239) or increases in fibrinogen concentration (Rsp of 0.280) during hospitalization and a worse prognosis. CONCLUSIONS AND CLINICAL IMPORTANCE: Measurement of plasma iron concentration better reflected acute inflammation than did fibrinogen concentration.