Skip to main content
Acta Veterinaria Scandinavica logoLink to Acta Veterinaria Scandinavica
. 1995 Jun 1;36(2):255–272. doi: 10.1186/BF03547694

D-Dimer Improves the Prognostic Value of Combined Clinical and Laboratory Data in Equine Gastrointestinal Colic

M Sandholm 19,, A Vidovic 29, A Puotunen-Reinert 29, S Sankari 19, K Nyholm 19, H Rita 39
PMCID: PMC8095414  PMID: 7484552

Abstract

The discriminating ability of 15 parameters alone or in combinations, including results from analysis of plasma endotoxin, the Nycomed plasma D-Dimer test and phospholipase A2, were analyzed to predict morbidity and mortality in equine gastrointestinal colic. Endotoxaemia was a characteristic feature of the colic horses. The problem of adequately predicting non-survivors among colic horses required several parameters to be included in the logistic model: if the “classical parameters”, (heart rate, respiratory rate, PCV, anion gap) were included in the model, addition of plasma D-dimer, phospholipase A2, and Cl- significantly improved the predictive value of the logistic model. Increasing heart rate and D-dimer together with decreasing chloride was a risk factor for nonsurvival. The sensitivity of this three-parameter logistic model to predict nonsurvival was 78% and specificity 77%. The Nycomed D-Dimer test is recommended as a horse-site test to predict disseminated intravascular coagulation and nonsurvival in equine colic.

Keywords: horse, diagnosis, acute phase, mortality, inflammation, enzymes, sorbitol dehydrogenase, phospholipase, glutamate dehydrogenase, endotoxin, acid-base, thrombosis, fibrinolysis, DIC

Full Text

The Full Text of this article is available as a PDF (2.4 MB).

Acknowledgments

We thank Vesa Rasi, MD and Elina Vahtera, Ph.Lic. Blood Coagulation Laboratory, Red Cross Blood Transfusion Service, Helsinki for analysing the fibrinogen content of the horse plasma standard by the fibrin-clot method and running the pilot tests on the applicability of the D-dimer test on equine plasma.

We thank Nycomed Pharma AS, Division Diagnostic POB 5012 Majorstua, N-0301 Oslo, Norway for donating the NycoCard D-Dimer tests for our disposal. We thank Professor Huskamp, head of the Hochmoor Animal Hospital for the colic material.

References

  1. Akira S, Taga T, Kishimoto T. Interleukin-6 in biology and medicine. Advances in Immunology. 1993;54:1–78. doi: 10.1016/S0065-2776(08)60532-5. [DOI] [PubMed] [Google Scholar]
  2. Aimer S, Franzen L, Olaison G, Smedh K, Strom M. Phospholipase A2 activity in colonic mucosa in patients with ulcerative colitis. Digestion. 1991;50:135–141. doi: 10.1159/000200753. [DOI] [PubMed] [Google Scholar]
  3. Crowl RM, Stoller TJ, Conroy RR, Stoner CR. Induction of phospholipase A2 gene expression in human hepatoma cells by mediators of the acute phase response. J.Biol.Chem. 1991;266:2647–2651. [PubMed] [Google Scholar]
  4. Darien BJ, Potempa J, Moore JN, Travis J. Antithrombin III activity in horses with colic; an analysis of 46 cases. Equine vet. J. 1991;23:211–214. doi: 10.1111/j.2042-3306.1991.tb02758.x. [DOI] [PubMed] [Google Scholar]
  5. Gerlach U, Hiby W. Sorbitol dehydrogenase. Methods of Enzymatic Analysis. 1974;2:569–573. doi: 10.1016/B978-0-12-091302-2.50008-6. [DOI] [Google Scholar]
  6. Gogstad GO, Dale S, Brosstad F, Brandnes, Holt-lund J, Mörk E, Gärtner E, Borch SM. Assay of D-dimer based on immunofiltration and staining with gold colloids. Clin. Chem. 1993;39:2070–2076. doi: 10.1093/clinchem/39.10.2070. [DOI] [PubMed] [Google Scholar]
  7. Gossett KA, Cleghorn B, Martin GS. Correlation between anion gap, blood lactate concentration and survival in horse. Equine vet. J. 1987;19:29–30. doi: 10.1111/j.2042-3306.1987.tb02573.x. [DOI] [PubMed] [Google Scholar]
  8. Johnston IB, Crane S. Haemostatic abnormalities in horses with colic - their prognostic value. Equine vet. J. 1986;18:271–274. doi: 10.1111/j.2042-3306.1986.tb03624.x. [DOI] [PubMed] [Google Scholar]
  9. King JN, Gerring EL. Detection of endotoxemia in cases of equine colic. Vet. Rec. 1988;123:269–271. doi: 10.1136/vr.123.10.269. [DOI] [PubMed] [Google Scholar]
  10. Morris DD. Endotoxemia in horses. A review of cellular and humoral mediators involved in its pathogenesis. J. vet. int. Med. 1991;5:167–181. doi: 10.1111/j.1939-1676.1991.tb00944.x. [DOI] [PubMed] [Google Scholar]
  11. Morris DD, Beech J. Disseminated intravascular coagulation in six horses. J. Amer. vet. med. Assoc. 1983;183:1067–1072. [PubMed] [Google Scholar]
  12. Morris DD, Moore JN, Crowe N, Moldawer LL. Effect of experimentally induced endotoxemia on serum interleukin-6 activity in horses. Amer. J. vet. Res. 1992;53:753–756. [PubMed] [Google Scholar]
  13. Orsini JA, Elser AH, Galligan DT, Donawick WJ, Kranfeld DS. Prognostic index for acute abdominal crisis (colic) in horses. Amer. J. vet. Res. 1988;49:1969–1971. [PubMed] [Google Scholar]
  14. Orsini JA, Galligan DT, Reeves M. Determining a prognosis for equine abdominal crisis (colic) Equine practice. 1991;13:9–14. [Google Scholar]
  15. Otamiri T, Tagesson C. Role of phospholipase A2 and oxygenated free radicals in mucosal damage after small intestinal ischemia and reperfusion. Amer. J. Surg. 1989;157:562–566. doi: 10.1016/0002-9610(89)90699-5. [DOI] [PubMed] [Google Scholar]
  16. Parry BW, Anderson GA, Gay CC. Prognosis in equine colic: A comparative study of variables used to assess individual cases. Equine vet. J. 1983;15:211–215. doi: 10.1111/j.2042-3306.1983.tb01768.x. [DOI] [PubMed] [Google Scholar]
  17. Prasse KW, Tropper MJ, Moore JN, Welles EG. Analysis of haemostasis in horses with colic. J. Amer. vet. med. Assoc. 1993;203:685–693. [PubMed] [Google Scholar]
  18. Puotunen-Reinert A. Study of variables commonly used in examination of equine colic cases to assess prognostic value. Equine vet. J. 1986;18:275–277. doi: 10.1111/j.2042-3306.1986.tb03626.x. [DOI] [PubMed] [Google Scholar]
  19. Puotunen-Reinert A, Sandholm M: Serum phospholipase A2 as a prognostic variable in equine colic. Proc. 2nd Equine Colic Research Symposium, Athens, Georgia 1985, 143–148.
  20. Reevers MJ, Curtis CR, Salman MD, Stashak TS, Reif JF. Validation of logistic regression models used in the assessment of prognosis and the need for surgery in equine colic. Prev. vet. Med. 1992;13:155–172. doi: 10.1016/0167-5877(92)90100-T. [DOI] [Google Scholar]
  21. Sobel JH, Thibodeau CA, Kolks MAG, Canfield RE. Isolation and partial structural characterization of an equine fibrinogen CNBr fragment that exhibits immunologic cross-reactivity with Aa chain cross-linking region of human fibrinogen. Biochemistry-Washington. 1990;29:8907–8916. doi: 10.1021/bi00490a005. [DOI] [PubMed] [Google Scholar]
  22. Waterman A. A review of the diagnosis and treatment of fluid and electrolyte disorders in the horse. Equine vet. J. 1977;9:43–48. doi: 10.1111/j.2042-3306.1977.tb03975.x. [DOI] [PubMed] [Google Scholar]
  23. Wei L, Floren CH. Hyperlipidemic response to endotoxin - a part of the host-defence mechanism. Scand. J. infect. Dis. 1993;25:675–682. doi: 10.3109/00365549309008562. [DOI] [PubMed] [Google Scholar]
  24. Wirth J. Dissertation. Germany: Ludwig-Maximilian University; 1986. Statistical investigation on 825 cases of equine colic at the Munich University Veterinary Clinic; p. 200. [Google Scholar]

Articles from Acta Veterinaria Scandinavica are provided here courtesy of BMC

RESOURCES