This document discusses using lactate levels to help determine the best treatment for a horse with colic. It explains that lactate is normally processed by muscles, liver and kidneys, but in cases of colic the production of lactate exceeds the body's ability to remove it due to endotoxemia, hypoperfusion and compromised organ function. Measuring lactate levels in peritoneal fluid or blood can help identify horses that are less likely to survive, with studies finding significantly higher levels in non-surviving horses. Taking lactate measurements is presented as a test that can help veterinarians make informed decisions about a horse's prognosis and appropriate treatment approach for colic cases.

1. Equine Colic; make a decision
IF ONLY IT WAS THAT EASY!

2. Learning outcomes
• Be able to decide on the best line of
treatment for a case of colic

3. Norma small intestine Dead small intestine
A colicky horse

4. The early you decide the better
is the outcome
30
35
40
45
50
PCV
0
10
20
30
40
Resection length in feet
00.20.40.60.8
Probabilityofdeath

5. So; how to find out before
opening the horse up

6. Revisiting an old notion

7. Fate of lactate
• Oxidation back to pyruvate by well-
oxygenated muscle
• Conversion to glucose in the liver and
release back into circulation
• Excretion by kidneys

8. Lactate and colic
• The production rate exceeds excretion rate.
• Switching from aerobic to anaerobic
metabolism of glucose due to Endotoxemia,
hypovolemia, and hypoperfusion
• The capacity of kidneys to excrete lactate is
compromised due to hypo-perfusion
• The capacity of the liver to recycle the
lactate is reduced since it is overwhelmed
with the circulating endotoxins

9. Measuring lactate in a colic
patient
• Normal value< 2mmol/l
• Survivors vs non survivors
(2.98 ± 5.53 vs. 9.48 ± 5.22
P < 0.001) (Johnston et al.,
2007)

10. 1. In peritoneal fluid
2.In blood
Lactate can be measured in

11. Learning outcome
• So you have now learnt one test that would
help you make a decision
Of course; there are many other
tests that you should do