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Diagnostic Accuracy of Blood Sucrose as a Screening Test for Diagnosis of Gastric Ulceration in Adult Horses
Author(s) -
Hewetson M.,
Sykes B.W.,
Hallowell G.,
Tulamo R.M.
Publication year - 2015
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12486_17
Subject(s) - medicine , sucrose , horse , gastroenterology , gold standard (test) , biology , paleontology , biochemistry
Reasons for performing study Gastric ulceration is an important cause of morbidity in horses. Currently, gastroscopy is the only reliable antemortem method for definitive diagnosis; however, it is unsuitable as a screening test because it is expensive, invasive and time‐consuming. Sucrose permeability testing represents a simple, economical, non‐invasive alternative to gastroscopy for screening purposes, and the feasibility of this approach in the horse has been reported [1]. Objectives To determine the diagnostic accuracy of blood sucrose as a screening test for gastric ulceration. Study design Cross‐sectional design. Methods One hundred and one adult horses with and without naturally occurring gastric ulcers were studied. The diagnostic accuracy of blood sucrose for detection of gastric ulcers at 45 and 90 min after administration of 1 g/kg bwt of sucrose via nasogastric intubation was assessed with ROC curves and calculating the area under the curve ( AUC ). Sucrose concentration in blood was compared with gastroscopy as the gold standard; and sensitivities ( S e) and specificities (Sp) were calculated across a range of sucrose concentrations. Cut‐off values were selected manually to optimise sensitivity. Results The prevalence of gastric ulcers was 83%. The AUC ± 95% CI for blood sucrose concentration when used to distinguish between horses with and without gastric ulcers at 45 and 90 min was 0.592 (0.441–0.744) and 0.615 (0.469–0.761) respectively. Sucrose concentrations of 4.70 μmol/l at 45 min; and 4.57 μmol/l at 90 min were selected as optimal cut‐offs. Using these cut‐offs, S e ranged from 64.4% to 77%; and Sp ranged from 42.9% to 50%. Conclusions Blood sucrose is neither a sensitive nor specific test for detecting gastric ulcers in adult horses with naturally occurring ulcers. Acknowledgements We thank S andy L ove, S atu S ankari, A nna‐ M aija V irtala, N oah C ohen, A llen R ousell, K aisa A altonen, A nne S jöholm and J ouni J unnila. Ethical animal research: The study protocol was approved by the National Animal Experiment Board of F inland (Eläinkoelautakunta ELLA ). For client‐owned animals, the informed consent of the owner was obtained. Source of funding: This study was funded by the Faculty of Veterinary Medicine, University of Helsinki, F inland. Competing interests: None declared.