Clinicopathological findings and their association with the outcome and development of laminitis in horses with acute diarrhea has not been investigated in a multicenter study across different geographic regions. The aim of this multicenter retrospective case series was to describe and compare clinicopathologic findings of diarrheic horses between different geographic regions, survival rates, and factors associated with nonsurvival and laminitis.
Study on Horses with Acute Diarrhea
Information from horses with acute diarrhea presenting to participating institutions between 2016 and 2020 was collected. Clinicopathological data were compared between surviving and nonsurviving horses and horses that did and did not develop laminitis. Survival rates and seasonal and geographic differences were also investigated.
The study included 1,438 horses from 26 participating institutions from four continents. Overall, 76% survived to discharge with no differences identified between geographic regions.
The presence of SIRS, altered mentation, toxic line on the oral mucosal membranes, and increased PCV, TP, creatinine, and lactate were significantly associated with increased odds of nonsurvival. The survival proportion of horses with SIRS and creatinine concentrations > 159 μmol/L was 55% (154/279) compared with 81% (358/437) of horses with SIRS and creatinine concentrations < 159 μmol/L (p < 0.001). The survival proportion of horses with SIRS that had an L-lactate concentration > 2.8 mmol/L was 59% (175/298) compared with 81% (240/296) in horses with SIRS and L-lactate concentration < 2.8 mmol/L (p < 0.001).
The proportion of horses that developed laminitis was lower in Europe (4%, 19/479) compared with North America (8%, 52/619), Australia (8%, 12/138), and Latin America (11%, 16/146) (p < 0.05). More horses developed laminitis in the summer (46%, 39/85) compared with winter (18%, 15/85), spring (18%, 15/85), and fall (19%, 16/85) (p < 0.01). Horses with laminitis had greater odds of nonsurvival than those without laminitis (OR: 3.73, 95% CI: 2.47–5.65).
Bottom Line
The presence of laminitis, SIRS, altered mentation, toxic line on the oral mucosal membranes, and increased PCV, TP creatinine, and lactate were significantly associated with increased odds of nonsurvival in horses with acute diarrhea.
