Diagnostic accuracy of d-dimer and other peritoneal fluid analysis measurements in dairy cows with peritonitis

Peritoneal fluid analysis in cattle traditionally includes the classic parameters despite the fact that they have only moderate diagnostic accuracy and often fail to identify the pathogenesis or etiological factors. Therefore additional parameters recently have been established to improve diagnostic precision. In a recent study, reference ranges for several of these parameters have been proposed in dairy cows.

The aim of this observational study was to assess the diagnostic value of D-Dimer and other measurements of peritoneal fluid analysis in dairy cows with peritonitis.

The study included 110 Holstein-Friesian cows grouped into cows with peritonitis (n = 47) and cows without peritonitis (n = 63).

Peritoneal fluid was obtained by abdominocentesis. Total protein, albumin, glucose, cholesterol, fibrinogen, l-lactate, D-Dimer, lactate dehydrogenase (LDH), alkaline phosphatase, creatine phosphokinase, white blood cell, and red blood cell were determined in peritoneal fluid and venous blood. Serum-ascites albumin gradient (SAAG) and ratios of peritoneal fluid-venous blood were calculated. Sensitivity (SN) and specificity (SP) were calculated and receiver operating characteristic curve analysis performed.

Peritoneal fluid D-Dimer was most accurate in diagnosing peritonitis in cows (SN and SP>95.0%). Total protein concentration, LDH and LDH ratio, and SAAG had sensitivities between 49.0 and 67.1%, and specificities between 88.4 and 95.5%. A low-peritoneal fluid glucose concentration was found to be highly indicative of septic peritonitis.

Measurement of the recently introduced parameters may increase the diagnostic value of peritoneal fluid analysis and provide additional specific information. Therefore these measurements should be included in the routine procedure.