Evaluation of serum amyloid A and haptoglobin concentrations as prognostic indicators for horses with inflammatory disease examined at a tertiary care hospital

Trina L. Westerman Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

Search for other papers by Trina L. Westerman in
Current site
Google Scholar
PubMed
Close
 DVM, MS
,
Susan J. Tornquist Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

Search for other papers by Susan J. Tornquist in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
,
Crystal M. Foster Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

Search for other papers by Crystal M. Foster in
Current site
Google Scholar
PubMed
Close
 BS
, and
Keith P. Poulsen Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

Search for other papers by Keith P. Poulsen in
Current site
Google Scholar
PubMed
Close
 DVM, PhD

Abstract

OBJECTIVE To evaluate use of serum amyloid A (SAA) and haptoglobin concentrations as prognostic indicators for horses with inflammatory disease in regard to euthanasia, complications, and hospitalization duration and cost.

ANIMALS 20 clinically normal horses and 53 horses with inflammatory disease.

PROCEDURES Total WBC count, neutrophil count, and fibrinogen, SAA, and haptoglobin concentrations were determined for clinically normal horses and horses with suspected inflammatory disease. Clinicopathologic values at admission were compared to test the use of SAA and haptoglobin concentrations in predicting euthanasia, complications, and hospitalization duration and cost. Haptoglobin and SAA concentrations of 22 horses were monitored during hospitalization to test the use of serial measurements in predicting survival and complications.

RESULTS Neutrophil count and SAA and haptoglobin concentrations were significantly different at admission for horses with inflammatory disease, compared with those for clinically normal horses. Horses with colitis and peritonitis had significantly higher SAA and haptoglobin concentrations than clinically normal horses. A moderate positive correlation (r = 0.355) between hospitalization duration and haptoglobin concentration was identified. Horses with an increase in SAA concentration between 24 and 72 hours after admission, compared with admission SAA concentration, were significantly more likely (OR, 7.0; 95% confidence interval, 1.1 to 45.9) to be euthanized or develop complications.

CONCLUSIONS AND CLINICAL RELEVANCE Concentrations of SAA and haptoglobin at admission were not significantly correlated with outcome in horses with inflammatory conditions. Acute-phase proteins likely have more utility in serial analysis rather than testing at a single time point for horses with inflammatory conditions.

Abstract

OBJECTIVE To evaluate use of serum amyloid A (SAA) and haptoglobin concentrations as prognostic indicators for horses with inflammatory disease in regard to euthanasia, complications, and hospitalization duration and cost.

ANIMALS 20 clinically normal horses and 53 horses with inflammatory disease.

PROCEDURES Total WBC count, neutrophil count, and fibrinogen, SAA, and haptoglobin concentrations were determined for clinically normal horses and horses with suspected inflammatory disease. Clinicopathologic values at admission were compared to test the use of SAA and haptoglobin concentrations in predicting euthanasia, complications, and hospitalization duration and cost. Haptoglobin and SAA concentrations of 22 horses were monitored during hospitalization to test the use of serial measurements in predicting survival and complications.

RESULTS Neutrophil count and SAA and haptoglobin concentrations were significantly different at admission for horses with inflammatory disease, compared with those for clinically normal horses. Horses with colitis and peritonitis had significantly higher SAA and haptoglobin concentrations than clinically normal horses. A moderate positive correlation (r = 0.355) between hospitalization duration and haptoglobin concentration was identified. Horses with an increase in SAA concentration between 24 and 72 hours after admission, compared with admission SAA concentration, were significantly more likely (OR, 7.0; 95% confidence interval, 1.1 to 45.9) to be euthanized or develop complications.

CONCLUSIONS AND CLINICAL RELEVANCE Concentrations of SAA and haptoglobin at admission were not significantly correlated with outcome in horses with inflammatory conditions. Acute-phase proteins likely have more utility in serial analysis rather than testing at a single time point for horses with inflammatory conditions.

Contributor Notes

Dr. Westerman's present address is Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

Dr. Poulsen's present address is Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

Address correspondence to Dr. Westerman (Trina.Westerman@gmail.com).
  • 1. Cray C, Zaias J, Altman NH. Acute phase response in animals: a review. Comp Med 2009; 59: 517526.

  • 2. Eckersall PD, Bell R. Acute phase proteins: biomarkers of infection and inflammation in veterinary medicine. Vet J 2010; 185: 2327.

    • Search Google Scholar
    • Export Citation
  • 3. Crisman MV, Scarratt WK, Zimmerman KL. Blood proteins and inflammation in the horse. Vet Clin North Am Equine Pract 2008; 24: 285297.

    • Search Google Scholar
    • Export Citation
  • 4. Jacobsen S, Andersen PH. The acute phase protein serum amyloid A (SAA) as a marker of inflammation in horses. Equine Vet Educ 2007; 19: 3846.

    • Search Google Scholar
    • Export Citation
  • 5. Wells B, Innocent GT, Eckersall PD, et al. Two major ruminant acute phase proteins, haptoglobin and serum amyloid A, as serum biomarkers during active sheep scab infestation. Vet Res [serial online]. 2013; 44: 103. Available at: www.veterinaryresearch.org/content/44/1/103. Accessed Apr 1, 2014.

    • Search Google Scholar
    • Export Citation
  • 6. Takata S, Wada H, Tamura M, et al. Kinetics of c-reactive protein (CRP) and serum amyloid A protein (SAA) in patients with community-acquired pneumonia (CAP), as presented with biologic half-life times. Biomarkers 2011; 16: 530535.

    • Search Google Scholar
    • Export Citation
  • 7. Cray C, Belgrave RL. Haptoglobin quantitation in serum samples from clinically normal and clinically abnormal horses. J Equine Vet Sci 2014; 34: 337340.

    • Search Google Scholar
    • Export Citation
  • 8. Sadrzadeh SM, Bozorgmehr J. Haptoglobin phenotypes in health and disorders. Am J Clin Pathol 2004; 121 (suppl): S97S104.

  • 9. Cerón JJ, Martinez-Subiela S, Ohno K, et al. A seven-point plan for acute phase protein interpretation in companion animals. Vet J 2008; 177: 67.

    • Search Google Scholar
    • Export Citation
  • 10. Christensen M, Jacobsen S, Ichiyanagi T, et al. Evaluation of an automated assay based on monoclonal anti-human serum amyloid A (SAA) antibodies for measurement of canine, feline, and equine SAA. Vet J 2012; 194: 332337.

    • Search Google Scholar
    • Export Citation
  • 11. Weidmeyer CE, Solter PF. Validation of human haptoglobin immunoturbidimetric assay for detection of haptoglobin in equine and canine serum and plasma. Vet Clin Pathol 1996; 25: 141146.

    • Search Google Scholar
    • Export Citation
  • 12. Belgrave RL, Dickey MM, Arheart KL, et al. Assessment of serum amyloid A testing of horses and its clinical application in a specialized equine practice. J Am Vet Med Assoc 2013; 243: 113119.

    • Search Google Scholar
    • Export Citation
  • 13. Canisso IF, Ball BA, Cray C, et al. Serum amyloid A and haptoglobin concentrations are increased in plasma of mares with ascending placentitis in the absence of changes in peripheral leukocyte counts or fibrinogen concentration. Am J Reprod Immunol 2014; 72: 376385.

    • Search Google Scholar
    • Export Citation
  • 14. Hultén C, Demmers S. Serum amyloid A (SAA) as an aid in the management of infectious disease in the foal: comparison with total leucocyte count, neutrophil count and fibrinogen. Equine Vet J 2002; 34: 693698.

    • Search Google Scholar
    • Export Citation
  • 15. Jacobsen S, Nielsen JV, Kjelgaard-Hansen M, et al. Acute phase response to surgery of varying intensity in horses: a preliminary study. Vet Surg 2009; 38: 762769.

    • Search Google Scholar
    • Export Citation
  • 16. Hultén C, Sandgren B, Skiöldebrand E, et al. The acute phase protein serum amyloid A (SAA) as an inflammatory marker in equine influenza virus infection. Acta Vet Scand 1999; 40: 323333.

    • Search Google Scholar
    • Export Citation
  • 17. Hultén C, Grönlund U, Hirvonen J, et al. Dynamics in serum of the inflammatory markers serum amyloid A (SAA), haptoglobin, fibrinogen and alpha2-globulins during induced non-infectious arthritis in the horse. Equine Vet J 2002; 34: 699704.

    • Search Google Scholar
    • Export Citation
  • 18. Wada A, Yamada T, Itoh Y, et al. Sensitive enzyme-linked immunosorbent assay for human serum amyloid A (SAA) and application to clearance study [in Japanese]. Rinsho Byori 1998; 46: 12521257.

    • Search Google Scholar
    • Export Citation
  • 19. Kluve-Beckerman B, Yamada T, Hardwick J, et al. Differential plasma clearance of murine acute-phase serum amyloid A proteins SAA1 and SAA2. Biochem J 1997; 322: 663669.

    • Search Google Scholar
    • Export Citation
  • 20. Jensen JU, Heslet L, Jensen TH, et al. Procalcitonin increase in early identification of critically ill patients at high risk of mortality. Crit Care Med 2006; 34: 25962602.

    • Search Google Scholar
    • Export Citation
  • 21. Sakata S, Yoshioka N, Atassi MZ. Human haptoglobin binds to human myoglobin. Biochim Biophys Acta 1986; 873: 312315.

  • 22. Malinoski DJ, Slater MS, Mullins RJ. Crush injury and rhabdomyolysis. Crit Care Clin 2004; 20: 171192.

  • 23. Shih AW, McFarlane A, Verhovsek M. Haptoglobin testing in hemolysis: measurement and interpretation. Am J Hematol 2014; 89: 443447.

    • Search Google Scholar
    • Export Citation
  • 24. Vandenplas ML, Moore JN, Barton MH, et al. Concentrations of serum amyloid A and lipopolysaccharide-binding protein in horses with colic. Am J Vet Res 2005; 66: 15091516.

    • Search Google Scholar
    • Export Citation
  • 25. Jain S, Gautam V, Naseem S. Acute-phase proteins: as diagnostic tool. J Pharm Bioallied Sci 2011; 3: 118127.

  • 26. Lobo SM, Lobo FR, Bota DP, et al. C-reactive protein levels correlate with mortality and organ failure in critically ill patients. Chest 2003; 123: 20432049.

    • Search Google Scholar
    • Export Citation

Advertisement