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

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.

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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.

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Sandholm, M., Vidovic, A., Puotunen-Reinert, A. et al. D-Dimer Improves the Prognostic Value of Combined Clinical and Laboratory Data in Equine Gastrointestinal Colic. Acta Vet Scand 36, 255–272 (1995). https://doi.org/10.1186/BF03547694

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Keywords

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