Interpreting abdominal fluid in colic horses: Understanding and applying peritoneal fluid evidence

Abstract

Background Interpreting changes in peritoneal fluid helps clinicians manage colic and other diseases in horses. During abdominal problems in the horse, abdominal fluid characteristics such as color, turbidity, total nucleated and red blood cell counts, cytology, total protein, and l‐lactate change in predictable ways, helping the clinician characterize the disease. Description Normal abdominal fluid in horses is odorless, clear to light yellow in color, and transparent. Peritoneal fluid becomes more turbid with increasing levels of protein, number of WBCs or RBCs, or with gross contamination following intestinal rupture. The color of abdominal fluid will also change with the type and quantity of cells or other elements present. The transformation of peritoneal fluid color from golden to orange to red represents increasing levels of RBCs, common with strangulating intestinal lesions. Serosanguinous defines fluid that is both turbid and orange to bloody because of increased total protein, WBCs, and RBCs, and is considered classic for diseases characterized by intestinal ischemia. Peritoneal fluid may also be red or blood‐colored because of a hemoperitoneum, or secondary to blood contamination during sample collection. l‐Lactate measurement in the abdominal fluid has proven invaluable for the identification of strangulating intestinal injury. Cytology acts as an important supplement to cell counts in peritoneal fluid, and the normal ratio of non‐degenerate neutrophils:mononuclear cells of 2:1 changes during various gastrointestinal diseases. Culture of peritoneal fluid samples should be performed when septic peritonitis is suspected. Summary Abdominal fluid is a sensitive indicator of intestinal injury and a useful tool to direct treatment. Peritoneal fluid evaluation includes gross visual and olfactory examination, nucleated cell count, total protein, RBC count, lactate levels, cytology, and culture. The changes noted in such variables are related to the type and duration of the abdominal problem. Key Points Abdominal fluid interpretation has become central to the triage and management of challenging equine colic patients. The transformation of peritoneal fluid color from golden to orange to red represents increasing levels of RBCs, common with strangulating intestinal lesions. Contamination with RBCs at various concentrations may be secondary to vascular (eg, abdominal wall or mesenteric vessels) or splenic trauma during abdominal fluid collection; however, this must be distinguished from orange to red fluid associated with intestinal strangulating obstruction or hemoabdomen Peritoneal fluid analysis reveals abdominal pathology by recognizing specific changes that occur with disease processes affecting the tissues and organs within this cavity. Abdominal fluid examination should be used as a tool to direct treatment rather than the definitive test for diagnosis of the acute abdomen Septic peritonitis in horses most commonly originates secondary to intestinal compromise or accidents (vascular da...

Incidence, risk factors, and therapeutic management of equine colic in Lamongan, Indonesia

“…In more severe cases, lethargy and shock appear to be the dominant symptoms. An obstruction in the intestine may alter intestinal anatomy, creating invaginations, volvuluses, or strangulation, accompanied by progressive pain and can be fatal [ 14 ].…”

Visualizing neutrophil extracellular traps in septic equine synovial and peritoneal fluid samples using immunofluorescence microscopy

“…For PF analysis, a TNCC ≥ 20 × 10 9 cells/L, TP > 30 g/L, and the presence of bacteria on cytology and/or bacterial growth on culture of PF were diagnostic for septic peritonitis. 2 , 53 Negative controls included samples with TNCC and TP within the RIs used at the VDL (i.e., peritoneal TNCC < 5 × 10 9 cells/L, TP < 25 g/L; synovial TNCC < 0.5 × 10 9 cells/L, TP < 20 g/L). Secondary antibody controls (elimination of primary antibodies) and labeling controls (elimination of all antibodies and dyes) were performed to evaluate nonspecific binding and autofluorescence ( Suppl.…”

Microbiota fecal, intestinal e translocação bacteriana em equinos com síndrome cólica cirúrgica

“…Nesses mesmos tipos de caso, resultados semelhantes são encontrados para análises de líquido peritoneal de outras naturezas (macroscópica, bioquímica, etc. ), em que podem apresentar resultados inconsistentes, com alterações subestimadas e que não acompanham o status clínico do paciente, pois essa alça intestinal está compartimentalizada, sem dividir as suas alterações com a maior parte do líquido peritoneal (RADCLIFFE et al, 2022). Em contrapartida, o outro grupo de delgado, composto por obstruções intraluminais e torções com o segmento intestinal posicionado dentro da cavidade, apresentou-se diferente do grupo controle, indicando que houve translocação bacteriana.…”

“…Até mesmo os casos de peritonite clínica, apresentam taxas menores de 40%, mesmo que haja indícios clínicos, de celularidade e de citologia, que confirmam presença de bactérias (ARNDT et al, 2021). Por conta desse cenário, a indicação para cultura de líquido peritoneal, costuma se dar principalmente em casos de peritonite séptica (RADCLIFFE et al, 2022), mas realizamos ambas as técnicas, na intenção de apresentarmos o contraste de que a cultura negativa não exclui a possibilidade de presença de bactérias, como visto nesse estudo.…”

“…Nesse ínterim, foi observada a associação de bactérias aos dois grupos de cólica, intestino grosso e delgado, que já foram anteriormente descritas na literatura em cultura de líquido peritoneal, como Streptococcus, Escherichia/Shigella, Actinobacillus, Burkholderia, Bacterioides e Fusobacterium (DEHEER; PARRY; RADCLIFFE et al, 2022). Porém, foram detectadas bactérias que não foram encontradas reportadas na literatura, em amostras de líquido peritoneal de equinos, como Gemella, Clostridium sensu stricto e as da família Lactobacillaceae, como, por exemplo, Limosilactobacillus e Ligilactobacillus.…”