Evaluation of cellular and biochemical parameters of blood
and peritoneal ¯uid following enterectomy in the goat
S. Nazifi
*, S. Dehghani, M.R. Barzegar
Department of Clinical Studies, School of Veterinary Medicine, Shiraz University, P.O. Box 1731, Shiraz 71345, Iran
Accepted 23 November 1999
Abstract
To evaluate the effects of enterectomy on cellular and biochemical parameters of blood and peritoneal ¯uid, an experiment was conducted using 10 Iranian crossbred male goats. Ten milliliter of blood and 1±1.5 ml of peritoneal ¯uid were sampled from all animals prior to operation for the estimation of control values. Enterectomy was performed under local anesthesia. Blood and peritoneal ¯uid samples were collected at 24, 48, 72 and 96 h after enterectomy. The results revealed that after enterectomy, the number of WBCs, neutrophils, monocytes and band neutrophils in the blood signi®cantly increased (p<0.05). However, the percent of lymphocytes decreased signi®cantly (p<0.05). The concentrations of glucose and blood urea nitrogen (BUN) signi®cantly increased (p<0.05). Furthermore, following the operation, the number of WBCs and the percent of neutrophils and band neutrophils in the peritoneal ¯uid signi®cantly increased (p<0.05). In contrast, the percent of lymphocytes and monocytes in the peritoneal ¯uid decreased signi®cantly (p<0.05). The concentrations of protein and the activities of amylase and alkaline phosphatase (ALP) in the peritoneal ¯uid increased signi®cantly (p<0.05). However, the concentration of glucose decreased signi®cantly (p<0.05). This study showed that enterectomy can have profound effects on blood and peritoneal ¯uid parameters.#2000 Elsevier Science B.V. All rights reserved.
Keywords:Goat; Enterectomy; Blood; Peritoneal ¯uid; Biochemical parameters; Cellular parameters
1. Introduction
Abdominal paracentesis is a valuable mean in the diagnosis of abdominal disease (Santschi et al., 1988). Peritoneal ¯uid analysis is a repeatable and informa-tive procedure to help assess severity of abdominal lesions, and may help to decide whether to perform abdominal surgery or not (Ducharme and Lowe, 1988). Surgical procedures involving the abdominal
cavity also involves the peritoneum. During healing, changes in the visceral and parietal peritoneum may affect the permeability of the peritoneal membrane to the body ¯uids. Surgical trauma to the abdominal wall and peritoneal and visceral surfaces during the celiot-omy is expected to cause postoperative in¯ammation (Crowe and Bjorling, 1985). Subsequently, peritoneal ¯uid volume increases and leukocytes migrate into the abdominal cavity. These changes cause dif®culty in interpretation of peritoneal ¯uid analysis after surgery. Alterations in the peritoneal ¯uid constituents have been reported after abdominal surgery (Santschi et al.,
Small Ruminant Research 37 (2000) 65±71
*Corresponding author.
1988) and as a result of intestinal infarction (Adams et al., 1980). Changes in peritoneal ¯uid constituents have been evaluated in horses after percutaneous enterocentesis and exploratory celiotomy, alone and after exploratory celiotomy with intestinal resection and anastomosis (Schumacher et al., 1985; Hanson et al., 1992). Changes in peritoneal ¯uid constituents have been described for left-sided displacement of the abomasum, traumatic reticuloperitonitis, septic peri-tonitis and exploratory celiotomy and omentopexy (Hirsch and Townsend, 1982; Wilson et al., 1985; Anderson et al., 1994). The concentration of electro-lytes in the peritoneal ¯uid of the goat following rumenotomy have been reported (Adamu et al., 1991). Serial peritoneal ¯uid evaluation is a useful indicator for assessing the response of peritonitis and abdominal trauma to medical treatment (Root et al., 1967; Traver et al., 1977; Dyson, 1983). Early identi-®cation of postoperative complications decreases the morbidity and mortality of these animals. However, unless obvious cytologic abnormalities exist, inter-pretation of peritoneal ¯uid values following extensive abdominal surgery has not been adequately de®ned. To our knowledge, serial evaluation of the peritoneal ¯uid following uncomplicated intestinal resection and anastomosis in goats has not been described. No published information is available regarding cellular and biochemical properties of the peritoneal ¯uid of the goat. The prime purpose of this study was therefore to determine the cellular and biochemical parameters of the peritoneal ¯uid of the goat in normal conditions. The other aim of this study was to document the cellular and biochemical characteristics of peritoneal ¯uid in goats following complicated and extensive intestinal resection and anastomosis and to compare these data with values in controls over a 4-day post-operative course.
2. Materials and methods
Ten Iranian crossbred male goats of 2±3 years age and ranging in body weight from 20 to 25 kg destined for slaughter were used for this study. They were in good condition and clinically normal. Prior to the experiment, they were dewormed using febendazole (10 mg/kg). Blood and peritoneal ¯uid samples were collected three times, every other day during a week, for determining the control values before any
opera-tion. Approximately 1±1.5 ml of peritoneal ¯uid was collected from each one of the goats before operation, to serve as control values. The most dependent part of abdomen which was 5 cm caudal to the xyphoid, and 5 cm left of the midline was shaved, prepared and anesthetized. A 24 gauge needle was used to aspirate peritoneal ¯uid aseptically. The samples were trans-ferred into a clean, sterile, labelled universal container. With the exception of the portion employed for total leukocyte and erythrocyte counts, all samples were centrifuged prior to further analysis and stored at ÿ208C until analysed. Prior to operation, the animals were starved for 24 h. The right ¯ank was shaved and prepared extensively for an aseptic operation. Anesthesia was induced locally by in®ltration of 1% lidocain HCl subcutaneously in an inverted L pattern. The middle of the ¯ank was incised 15 cm long. The abdominal organs were inspected through the celiotomy incision and a part of jeojinum was selected which was isolated from the rest of viscera by sterile towel. Five centimeter of jeojinum was resected and the rest were anastomosed by an end to end technique using 2/0 chromic catgut in simple inter-rupted pattern. The intestine was rinsed by sterile normal saline and was replaced back in the peritoneal cavity. The celiotomy incision was sutured routinely. A folly catheter was installed into the peritoneal cavity through a skin incision 10 cm cranial to the last rib by ventral commisure of the celiotomy incision for ease of collection of peritoneal ¯uid postoperatively. None of the animals received antibiotic postoperatively. About 1±1.5 ml of peritoneal ¯uid was collected from each of the experimental animals on 24, 48, 72 and 96 h after enterectomy. For the hematological analysis blood samples were collected by jugular venepuncture into vacutainers containing EDTA as an anticoagulant. For the serum biochemical analysis, blood samples were collected into vacutainers and the serum was separated by centrifuge and was stored in deep freeze until use. The blood values were estimated through standard hematological techniques (Jain, 1986). Total RBC and WBC counts in peritoneal ¯uid were done using a standard haemacytometer. Differential leuko-cyte counts were made from Giemsa stained smears of the sediment following centrifugation of the peritoneal ¯uid (Coles, 1986).
Biochemical analysis including serum and perito-neal ¯uid total protein was done by the Biuret method,
glucose by the O-Toluidine method, urea nitrogen by the Diacetyl monoxime method, chloride by the col-orimetric (mercuric nitrate) method, inorganic phos-phorus by the ammonium molybdate method, CK by the sigma colorimetric (Modi®ed Hughes) method, ALP by modi®ed method of Bowers and McComb, amylase by amyloclastic method. All the enzyme activities were measured at 378C and the results have been presented in U/l (Burtis and Ashwood, 1994). The concentration of sodium and potassium in the serum and the peritoneal ¯uid were measured by the ¯ame photometric method (Flame photometer, FLM2, Ontario, Canada). The samples were analysed for magnesium and calcium by the atomic absorption spectrophotometer (Shimadzo, AA-670, Kyoto, Japan). The data were expressed in SI unit and analysed statistically by nested design. All values were expressed in meanstandard error (SE) using a sig-ni®cant level ofp<0.05.
3. Results
There were no serious clinical complications in any of the 10 experimental animals following enterect-omy. The mean temperature, respiration rate and pulse rate of the experimental animals after surgery were 39.60.68C, 20.92.9 and 91.415 per min, respec-tively. The surgical wounds healed uneventfully and the stitches were removed on 12th postoperative day. The meanstandard error of hematological and serum biochemical parameters of Iranian goats before and after enterectomy are presented in Tables 1 and 2, respectively.
The meanstandard error of cellular and biochem-ical parameters in the peritoneal ¯uid of Iranian goats before and after enterectomy are presented in Tables 3 and 4, respectively.
The results revealed that after enterectomy, the number of WBCs, neutrophils, monocytes, band neu-trophils and lymphocytes and the concentrations of serum glucose and BUN were signi®cantly different as compared with control group (p<0.05). The number of WBCs, neutrophils, monocytes and band neutrophils signi®cantly increased (p<0.05). However, the percent of lymphocytes decreased signi®cantly (p<0.05). The concentrations of serum glucose and BUN signi®-cantly increased (p<0.05).
Following the operation, the number of WBCs and the percent of neutrophils, band neutrophils, lympho-cytes and monolympho-cytes and the concentrations of protein and glucose and the activities of amylase and ALP in the peritoneal ¯uid were signi®cantly different as compared with control group (p<0.05). The number of WBCs and the percent of neutrophils and band neutrophils in the peritoneal ¯uid signi®cantly increased (p<0.05). In contrast, the percent of lym-phocytes and monocytes in the peritoneal ¯uid decreased signi®cantly (p<0.05). The concentrations of protein and the activities of amylase and ALP in the peritoneal ¯uid increased signi®cantly (p<0.05). How-ever, the concentration of glucose decreased signi®-cantly (p<0.05).
4. Discussion
Identifying early complications after abdominal surgery in animals can be dif®cult. No antibiotic was used since they would cause some adverse effects on cellular and noncellular components in the perito-neal cavity. Monitoring of the peritoperito-neal ¯uid and peripheral blood can help in identifying such compli-cations as peritonitis, wound dehiscence and devita-lized bowels (Oehme, 1969; Bright, 1986). However, the lack of reference values for postoperative perito-neal ¯uid makes interpretation of results dif®cult. The results obtained in this study indicates that the surgery has an effect on the cellular and biochemical values in the blood and peritoneal ¯uid of goats following enterectomy. In the operated goats, slight fever was due to animal reaction, increase in neutrophil counts and release of pyrogenic mediators (Jain, 1993; Dun-can et al., 1994). The number of WBCs, neutrophils, monocytes, and band neutrophils signi®cantly increased (p<0.05). In contrast, the percent of lym-phocytes decreased signi®cantly (p<0.05). These changes in hematological parameters are probably due to reactive leukocytosis and stress (Coles, 1986; Jain, 1993).
The concentration of serum glucose signi®cantly increased (p<0.05). The increase in glucose concen-tration may be probably due to stress and endogenous glucocorticoids release from adrenal glands (Kaneko, 1989). The concentration of BUN signi®cantly increased (p<0.05). The increase in BUN
Table 1
The meanstandard error of hematological parameters of Iranian goats before and after enterectomy (n10) Days after
Neutrophila Lymphocytea Eosinophil Monocytea Basophil Band neutrophila
(%) 109(l) (%)
aValues with different letters in a column differ signi®cantly (p<0.05).
Table 2
The meanstandard error of serum biochemical parameters of Iranian goats before and after enterectomy (n10) Days
CK (IU/l) Amylase (IU/l)
aValues with different letters in a column differ signi®cantly (p<0.05).
Table 3
The meanstandard error of cellular parameters in the peritoneal ¯uid of Iranian goats before and after enterectomy (n10) Days after
Neutrophila Lymphocytea Eosinophil Monocytea Band neutrophila
(%) 109(l) (%)
aValues with different letters in a column differ signi®cantly (p<0.05).
Table 4
The meanstandard error of biochemical parameters in the peritoneal ¯uid of Iranian goats before and after enterectomy (n10) Days
aValues with different letters in a column differ signi®cantly (p<0.05).
tion may be probably due to catabolic breakdown of the tissues as a consequence of fever and trauma (prerenal azotemia). The number of WBCs and the percent of neutrophils and band neutrophils in the peritoneal ¯uid signi®cantly increased due to post-operative in¯ammatory response. Our results were similar to ®ndings of Adamu et al. (1991) in goats, Anderson et al. (1994) in cattle, Santschi et al. (1988) in ponies and Schumacher et al. (1985) in horse. The percent of lymphocytes and monocytes in the perito-neal ¯uid decreased signi®cantly (p<0.05). In contrast to our results, after enterocentesis in horse and exploratory celiotomy and omentopexy in cattle, the number of lymphocytes and mononuclear cells increased signi®cantly (Schumacher et al., 1985; Anderson et al., 1994).
Following the enterectomy, the concentration of protein in the peritoneal ¯uid increased signi®cantly obviously due to in¯ammation and postsurgical com-plications. Marked signi®cant increases in peritoneal ¯uid total protein concentration has been observed after exploratory surgery in horses, cattle and goats (Santschi et al., 1988; Adamu et al., 1991; Hanson et al., 1992; Anderson et al., 1994). The concent-ration of glucose in the peritoneal ¯uid decreased signi®cantly probably due to increased use of glucose by leukocytes and bacteria found in the peritoneal ¯uid. The activity of amylase in the peri-toneal ¯uid increased signi®cantly (p<0.05). The increase in amylase activity of the peritoneal ¯uid probably results from escape of the enzyme from the duodenal mucosa in the peritoneal cavity. Duodenal mucosa is the most likely source of normal serum amylase activity (Duncan et al., 1994). Crowe and Crane (1976) showed that in intestinal ischemia the activity of peritoneal amylase is increased. The activ-ity of ALP in the peritoneal ¯uid increased signi®-cantly (p<0.05). The increase in ALP activity of the peritoneal ¯uid probably results from intestinal iso-enzyme of ALP. Intestinal mucosa is the richest source of ALP. The serum half-life of intestinal isoenzyme is very short (<6 min) therefore this isoenzyme is not responsible for increase in serum ALP (Duncan et al., 1994).
There was no signi®cant differences in sodium, potassium and chloride of peritoneal ¯uid. In contrast to our results, Adamu et al. (1991) reported that after rumenotomy in goats, sodium and chloride values in
peritoneal ¯uid decreased signi®cantly and potassium value increased signi®cantly.
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