Alkaline phosphatase (ALP) is an enzyme present in intestinal mucosa,
bile, bone and renal tubule cells. Bile acids have been shown to decrease ALP
activity from bone and kidney but not those from intestinal origin. This action can
be mimicked in serum and peritoneal fluid samples by the use of an L-phenylalanine
buffer which specifically measures intestinal ALP activity only;
while the standard buffer measures total ALP activity. We sought to assess the
diagnostic and prognostic relationship of intestinal and total ALP activity between
serum and peritoneal fluid in 126 horses with acute colic. Blood and peritoneal
fluid samples were analyzed for ALP activity using both the standard and L-phenylalanine
based buffers. Neither total nor intestinal serum ALP activity was
useful in classifying type or severity of intestinal damage. Total and intestinal
peritoneal fluid ALP activity were lowest in horses suffering simple medical colic
and non-strangulated surgical lesions, and highest in surgical cases with suspected
ulceration, strangulation, peritonitis and intestinal rupture. High total and intestinal
peritoneal fluid ALP activity was associated with greater intestinal damage,
increased probability of surgical intervention and a worse prognosis while low
total and intestinal peritoneal fluid ALP activity was unable to accurately
differentiate between simple medical colics and surgical colics. The use of L-phenylalanine
buffer in both serum and peritoneal fluid did not improve the
sensitivity of the test. Based on these results, determination of total ALP activity in
peritoneal fluid may be helpful in identifying ischemic or inflammatory bowel
lesions in horses with acute colic.
A portable clinical analyzer (PCA) was used for the determination of
venous blood and peritoneal fluid pH value, glucose, lactate and electrolyte
concentrations in a hospital setting. Blood and peritoneal fluid glucose, lactate,
sodium, chloride and potassium concentrations, and pH value were determined
using both a portable clinical analyzer with test cartridges and an in-house
analyzer in 56 horses with acute abdominal disease. Results were compared by the
Bland-Altman method of comparison and linear regression. The PCA yielded
higher blood and peritoneal pH values, with greater variability in the alkaline
range and lower pH values in the acidic range. The PCA glucose concentrations
(<150 mg/dL) were significantly lower, and were higher in the high range (>150
mg/dL). Venous lactate concentration (<5 mmol/dL) arid peritoneal fluid lactate
concentration (<2 mmol/dL) had the smallest variability. On average, the PCA
underestimated peritoneal lactate and glucose concentration. Peritoneal fluid
sodium and chloride concentration had higher bias and variability than venous sodium and chloride concentration. Venous and peritoneal fluid potassium
concentration was closely clustered around the mean with a low bias and
variability. Correlation coefficients were >0.80 for all values except venous and
peritoneal sodium concentration; venous chloride concentration and venous pH
value. The PCA may be suitable for point-of-care biochemical analysis of blood
and peritoneal fluid for horses suffering colic and may provide further diagnostic
and prognostic information. The PCA may be of help in diagnosing metabolic
acidosis, uroperitoneum, septic and non-septic peritonitis and intestinal ischemia.
This may be of benefit to ambulatory equine clinicians. / Graduation date: 2004
| Identifer | oai:union.ndltd.org:ORGSU/oai:ir.library.oregonstate.edu:1957/30812 |
| Date | 23 October 2003 |
| Creators | Saulez, Montague N. |
| Contributors | Cebra, Christopher K. |
| Source Sets | Oregon State University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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