Blood Protein to Diagnose Surgical vs. Nonsurgical Colic

Blood Protein to Diagnose Surgical vs. Nonsurgical Colic

Colic in horses can range from a benign bellyache to a life-threatening condition requiring emergency surgery.


Colic in horses can range from a benign bellyache to a life-threatening condition requiring emergency surgery. And while in most cases veterinarians identify severe colic cases relatively easily, they might have a more difficult time deciding if such cases require surgery or if they can be managed medically.

There might be hope, however, for veterinarians that must make this decision for certain colic case types—those with infectious causes. Danish researchers recently evaluated whether practitioners could use certain blood protein levels to distinguish surgical from nonsurgical colic cases. They presented their results at the 2013 American Association of Equine Practitioners’ Convention, held Dec. 7-11 in Nashville, Tenn.

The team looked at levels of three proteins--serum amyloid A, haptoglobin, and fibrinogen--as diagnostic markers for these infectious nonsurgical vs. surgical colics. These proteins are, noted Tina Holberg Pihl, DVM, PhD, assistant professor of medicine and surgery at the University of Copenhagen's Department of Large Animal Sciences, the most important “acute phase proteins” in the horse, levels of which rise when the horse fights inflammation .

The researchers studied these levels separately as well as in conjunction with analyzing common blood and peritoneal fluid (that which surrounds and lubricates the abdominal organs) factors such as white cell count, packed cell volume, total protein, and lactate to see if including these proteins could improve diagnostic accuracy. In doing so they examined records from 148 cases of severe colic.

Pihl said the researchers found serum amyloid A (SAA) was the best marker for differentiating between infectious nonsurgical and surgical colic, noting that “High SAA and fibrinogen concentrations in serum will increase the likelihood that a horse with severe colic has a primary inflammatory disease requiring medical therapy and not a disease requiring surgery.” Other markers, including haptoglobin, were not found to improve the predictive value of the model.

She noted that the white blood cell count that veterinarians traditionally use to try to distinguish infectious gastrointestinal disease from surgical colic did not perform as well as predictors of inflammatory disease in this study. Lactate, another blood and peritoneal fluid marker veterinarians use to evaluate colic, also was not useful for distinguishing surgical from nonsurgical candidates.

In conclusion, Pihl said SAA concentrations might help veterinarians determine which horses truly need surgery and assist them in evaluating response to treatment in nonsurgical infectious colics.

About the Author

Christy Corp-Minamiji, DVM

Christy Corp-Minamiji, DVM, practices large animal medicine in Northern California, with particular interests in equine wound management and geriatric equine care. She and her husband have three children, and she writes fiction and creative nonfiction in her spare time.

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