# New Diagnostic Score for Sepsis in Adult Horses with Acute Gastrointestinal Disease

## TL;DR

This study developed a new diagnostic score to help veterinarians detect sepsis in adult horses with digestive issues, using six key clinical and lab parameters.

## Contribution

The study introduces a novel sepsis diagnostic score specifically for adult horses with acute gastrointestinal disease.

## Key findings

- A sepsis score using six parameters (temperature, heart rate, leukocyte count, red blood cells, creatine kinase, and lactate) was developed with 79% accuracy.
- At a threshold of 3, the score achieved 52.7% sensitivity and 91.6% specificity for sepsis detection.
- The score is practical and highly specific for confirming sepsis in horses with acute gastrointestinal disease.

## Abstract

Colic is a common and serious digestive problem in adult horses that can become life-threatening when it causes widespread inflammation and organ failure. Recognizing when a horse develops a severe infection that leads to sepsis is difficult because no standard method exists. This study aimed to create a simple tool to help veterinarians detect sepsis early in horses with acute digestive problems. By reviewing the medical records of 295 horses admitted for colic over ten years, six key signs were identified, including body temperature, heart rate, blood cell counts, and certain blood chemicals, which together predict the risk of sepsis. These signs were combined into a scoring system that is easy to use and can guide decisions about urgent treatment. Early recognition of sepsis may improve survival, reduce complications, and help veterinarians and owners manage affected horses more effectively.

Colic is a leading cause of mortality in horses, particularly when associated with systemic inflammation and organ dysfunction. In human medicine, these complications are associated with sepsis, defined as organ dysfunction caused by a dysregulated, life-threatening host response to infection. However, no consensus sepsis score exists for adult horses. This retrospective study aimed to develop a diagnostic sepsis score for adult horses. Medical records from 295 horses admitted for colic to the Oniris equine emergency department (Nantes, France) between July 2011 and November 2021 were analyzed. Horses were classified as having sepsis or colic based on their final diagnosis. Clinical and laboratory parameters were assessed, and univariate and multivariate logistic regression analyses yielded a predictive score. The optimal threshold was determined by maximizing sensitivity and specificity. Sepsis was diagnosed in 89 horses (30.2%). Six parameters—temperature, heart rate, leukocyte count, red blood cells, creatine kinase, and lactate—were included in the model. The score showed 79% accuracy, with 59% sensitivity and 88% specificity. At a threshold of 3, sensitivity was 52.7%, specificity was 91.6%, and the Youden index was 0.44. This study proposes a rapid, practical sepsis diagnostic score for adult horses with acute gastrointestinal disease, serving as a highly specific tool for confirming sepsis.