Evaluation of a point-of-care portable analyzer for measurement of plasma immunoglobulin G, total protein, and albumin concentrations in ill neonatal foals

David M. Wong Lloyd Veterinary Medical Center, Department of Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

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Steeve Giguère Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

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Mara A. Wendel Section of Internal Medicine, Rood and Riddle Equine Hospital, 2150 Georgetown Rd, Lexington, KY 40511.

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Abstract

Objective—To compare the diagnostic performance of a point-of-care (POC) analyzer with that of established methods for the measurement of plasma IgG, total protein, and albumin concentrations in neonatal foals.

Design—Evaluation study.

Animals—100 neonatal foals < 7 days of age.

Procedures—Plasma IgG, total protein, and albumin concentrations were measured with a POC analyzer via an immunoturbidimetric method. Corresponding measurements of plasma IgG, total protein, and albumin concentrations were measured by means of automated biochemical analyzers via automated immunoturbidimetric, biuret, and bromocresol green dye–binding assays, respectively (standard laboratory methods).

Results—The sensitivity and specificity of the POC analyzer for detection of failure of passive transfer of immunity (FPTI) in foals were 80.7% and 100%, respectively, when FPTI was defined as a plasma IgG concentration < 400 mg/dL and were 75.9% and 100%, respectively, when FPTI was defined as a plasma IgG concentration < 800 mg/dL. The POC analyzer overestimated plasma albumin concentrations and, to a lesser extent, plasma total protein concentrations, compared with values determined with the standard laboratory methods.

Conclusions and Clinical Relevance—Results suggested the POC analyzer was acceptable for determination of plasma IgG and total protein concentrations in ill foals. The POC analyzer overestimated plasma albumin concentration such that its use was clinically unacceptable for the determination of that concentration. The POC analyzer provided timely measurements of plasma IgG concentrations, which is necessary information for the assessment of passive transfer of maternal antibodies to neonatal foals.

Abstract

Objective—To compare the diagnostic performance of a point-of-care (POC) analyzer with that of established methods for the measurement of plasma IgG, total protein, and albumin concentrations in neonatal foals.

Design—Evaluation study.

Animals—100 neonatal foals < 7 days of age.

Procedures—Plasma IgG, total protein, and albumin concentrations were measured with a POC analyzer via an immunoturbidimetric method. Corresponding measurements of plasma IgG, total protein, and albumin concentrations were measured by means of automated biochemical analyzers via automated immunoturbidimetric, biuret, and bromocresol green dye–binding assays, respectively (standard laboratory methods).

Results—The sensitivity and specificity of the POC analyzer for detection of failure of passive transfer of immunity (FPTI) in foals were 80.7% and 100%, respectively, when FPTI was defined as a plasma IgG concentration < 400 mg/dL and were 75.9% and 100%, respectively, when FPTI was defined as a plasma IgG concentration < 800 mg/dL. The POC analyzer overestimated plasma albumin concentrations and, to a lesser extent, plasma total protein concentrations, compared with values determined with the standard laboratory methods.

Conclusions and Clinical Relevance—Results suggested the POC analyzer was acceptable for determination of plasma IgG and total protein concentrations in ill foals. The POC analyzer overestimated plasma albumin concentration such that its use was clinically unacceptable for the determination of that concentration. The POC analyzer provided timely measurements of plasma IgG concentrations, which is necessary information for the assessment of passive transfer of maternal antibodies to neonatal foals.

Contributor Notes

Dr. Giguère's present address is Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

No extrainstitutional funding was used to support this study.

The authors declare no conflicts of interest in regard to this study.

The authors thank Elliott Williams for technical assistance.

Address correspondence to Dr. Wong (dwong@iastate.edu).
  • 1. Sellon DC, Hines MT, Johnson JR. Immunologic disorders: equine immunodeficiency diseases. In: Smith BP, ed. Large animal internal medicine. 4th ed. St Louis: Mosby, 2009; 16671671.

    • Search Google Scholar
    • Export Citation
  • 2. Giguère S, Polkes AC. Immunologic disorders in neonatal foals. Vet Clin North Am Equine Pract 2005; 21: 241272.

  • 3. Holznagel DL, Hussey S, Mihalyi JE, et al. Onset of immunoglobulin production in foals. Equine Vet J 2003; 35: 620622.

  • 4. Sheoran AS, Timoney JF, Holmes MA, et al. Immunoglobulin isotypes in sera and nasal mucosal secretions and their neonatal transfer and distribution in horses. Am J Vet Res 2000; 61: 10991105.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Tyler-McGowan CM, Hodgson JL, Hodgson DR. Failure of passive transfer in foals: incidence and outcome on four studs in New South Wales. Aust Vet J 1997; 75: 5659.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Robinson JA, Allen GK, Green EM, et al. A prospective study of septicaemia in colostrum-deprived foals. Equine Vet J 1993; 25: 214219.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. McGuire TC, Crawford TB, Hallowell AL, et al. Failure of colostral immunoglobulin transfer as an explanation for most infections and deaths of neonatal foals. J Am Vet Med Assoc 1977; 170: 13021304.

    • Search Google Scholar
    • Export Citation
  • 8. Morris DD, Meirs DA, Merryman GS. Passive transfer failure in horses: incidence and causative factors on a breeding farm. Am J Vet Res 1985; 46: 22942299.

    • Search Google Scholar
    • Export Citation
  • 9. Raidal SL. The incidence and consequences of failure of passive transfer of immunity on a Thoroughbred farm. Aust Vet J 1996; 73: 201206.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Kohn CW, Knight D, Hueston W, et al. Colostral and serum IgG, IgA, and IgM concentrations in Standardbred mares and their foals at parturition. J Am Vet Med Assoc 1989; 195: 6468.

    • Search Google Scholar
    • Export Citation
  • 11. LeBlanc MM, Tran T, Baldwin JL, et al. Factors that influence passive transfer of immunoglobulins in foals. J Am Vet Med Assoc 1992; 200: 179183.

    • Search Google Scholar
    • Export Citation
  • 12. Baldwin JL, Cooper WL, Vanderwall DK, et al. Prevalence (treatment days) and severity of illness in hypogammaglobulinemic and normogammaglobulinemic foals. J Am Vet Med Assoc 1991; 198: 423428.

    • Search Google Scholar
    • Export Citation
  • 13. Clabough DL, Levine JF, Grant GL, et al. Factors associated with failure of passive transfer of colostral antibodies in Standardbred foals. J Vet Intern Med 1991; 5: 335340.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Haas SD, Bristol F, Card CE. Risk factors associated with the incidence of foal mortality in an extensively managed mare herd. Can Vet J 1996; 37: 9195.

    • Search Google Scholar
    • Export Citation
  • 15. Perryman LE, McGuire TC. Evaluation for immune system failures in horses and ponies. J Am Vet Med Assoc 1980; 176: 13741377.

  • 16. Davis R, Giguère S. Evaluation of five commercially available assays and measurement of serum total protein concentration via refractometry for the diagnosis of failure of passive transfer of immunity in foals. J Am Vet Med Assoc 2005; 227: 16401645.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17. Sacks DB. Analytes: carbohydrates. In: Burtis CA, Ashwood ER, eds. Tietz fundamentals of clinical chemistry. 5th ed. Philadelphia: WB Saunders Co, 2001; 427461.

    • Search Google Scholar
    • Export Citation
  • 18. Bauer JE, Brooks TP. Immunoturbidimetric quantification of serum immunoglobulin G concentration in foals. Am J Vet Res 1990; 51: 12111214.

    • Search Google Scholar
    • Export Citation
  • 19. McCue PM. Evaluation of a turbidimetric immunoassay for measurement of plasma IgG concentration in foals. Am J Vet Res 2007; 68: 10051009.

  • 20. Davis DG, Schaefer DMW, Hinchcliff KW, et al. Measurement of serum IgG in foals by radial immunodiffusion and automated turbidimetric immunoassay. J Vet Intern Med 2005; 19: 9396.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Magdesian KG. Neonatal foal diarrhea. Vet Clin North Am Equine Pract 2005; 21: 295312.

  • 22. Clayton HM, Duncan JL, Dargie JD. Pathophysiological changes associated with Parascaris equorum infection in the foal. Equine Vet J 1980; 12: 2325.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Frazer ML. Lawsonia intracellularis infection in horses: 2005–2007. J Vet Intern Med 2008; 22: 12431248.

  • 24. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000; 45: 2341.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307310.

    • Search Google Scholar
    • Export Citation
  • 26. Lin LI-K. A concordance correlation coefficient to evaluate reproducibility. Biometrics 1989; 45: 255268.

  • 27. Lin LI-K. A note on the concordance correlation coefficient. Biometrics 2000; 56: 324325.

  • 28. Wilkins PA. The equine neonatal intensive care laboratory: point-of-care testing. Clin Lab Med 2011; 31: 125137.

  • 29. Hollis AR, Dallap Schaer BL, Boston RC, et al. Comparison of the Accu-Chek Aviva point-of-care glucometer with blood gas and laboratory methods of analysis of glucose measurement in equine emergency patients. J Vet Intern Med 2008; 22: 11891195.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Hackett ES, McCue PM. Evaluation of a veterinary glucometer for use in horses. J Vet Intern Med 2010; 24: 617621.

  • 31. Tennent-Brown BS, Wilkins PA, Lindborg S, et al. Assessment of a point-of-care lactate monitor in emergency admissions of adult horses to a referral hospital. J Vet Intern Med 2007;21: 10901098.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. Kraus MS, Jesty SA, Gelzer AR, et al. Measurement of plasma cardiac troponin I concentration by use of a point-of-care analyzer in clinically normal horses and horses with experimentally induced cardiac disease. Am J Vet Res 2010; 71: 5559.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33. Chevalier H, Posner LP, Ludders JW, et al. Accuracy and precision of a point-of-care hemoglobinometer for measuring hemoglobin concentration and estimating packed cell volume in horses. J Am Vet Med Assoc 2003; 223: 7883.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34. Grosenbaugh DA, Gadawski JE, Muir WW. Evaluation of a portable clinical analyzer in a veterinary hospital setting. J Am Vet Med Assoc 1998; 213: 691694.

    • Search Google Scholar
    • Export Citation
  • 35. Looney AL, Ludders J, Erb HN, et al. Use of a handheld device for analysis of blood electrolyte concentrations and blood gas partial pressures in dogs and horses. J Am Vet Med Assoc 1998; 213: 526530.

    • Search Google Scholar
    • Export Citation
  • 36. Silverman SC, Birks EK. Evaluation of the i-STAT hand-held chemical analyzer during treadmill and endurance exercise. Equine Vet J Suppl 2002;(34): 551554.

    • Search Google Scholar
    • Export Citation
  • 37. Viljoen A, Saulez MN, Carstens A, et al. The impact of ultrasound during emergency after-hour admission in horses. J S Afr Vet Assoc 2010; 81: 216218.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38. Raidal SL, McTaggart C, Penhale J. Effect of withholding macro-molecules on the duration of intestinal permeability to colostral IgG in foals. Aust Vet J 2005; 83: 7881.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39. Sellon DC. Secondary immunodeficiencies of horses. Vet Clin North Am Equine Pract 2000; 16: 117130.

  • 40. Metzger N, Hinchcliff KW, Hardy J, et al. Usefulness of a commercial equine IgG test and serum protein concentration as indicators of failure of transfer of passive immunity in hospitalized foals. J Vet Intern Med 2006; 20: 382387.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41. Bertone JJ, Jones RL, Curtis CR. Evaluation of a test kit for determination of serum immunoglobulin G concentration in foals. J Vet Intern Med 1988; 2: 181183.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42. Pusterla N, Pusterla JB, Spier SJ, et al. Evaluation of the SNAP Foal IgG test for the semiquantitative measurement of immunoglobulin G in foals. Vet Rec 2002; 151: 258260.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43. George JW, O'Neill SL. Comparison of refractometer and biuret methods for total protein measurement in body cavity fluids. Vet Clin Pathol 2001; 30: 1618.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44. Carlson GP, Harrold DR. Relationship of protein concentration and water content of equine serum and plasma samples. Vet Clin Pathol 1977; 6: 1820.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45. Bauer JE. Normal blood chemistry. In: Koterba AM, Drummond WA, Kosch PC, eds. Equine clinical neonatology. Philadelphia: Lea & Febiger, 1990; 602622.

    • Search Google Scholar
    • Export Citation

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