SUCCEED® Equine Fecal Blood Test

SUCCEED Equine Fecal Blood Test
The SUCCEED Equine Fecal Blood Test is a simple stall-side diagnostic aid to detect the presence of gastrointestinal pathologies in horses. This simple, highly sensitive test detects the presence of occult blood in a fresh fecal sample and may give some indication of location of the source.

The Need for Improved Diagnostics

Much attention is paid to the equine stomach. Yet, the stomach represents only 5 to 10% of the volume of the entire equine GI tract. By contrast, the hindgut is large and important to the digestive process.

It’s also vulnerable to health issues that can place the animal at significant risk, including parasites, ulcers, infection, peritonitis, colitis and, of course, colic.

Unfortunately, the colon is also impossible to visualize, impairing the veterinarian’s diagnosis.

The SUCCEED Equine Fecal Blood Test changes all of that. With the SUCCEED FBT, veterinarians can obtain reliable objective data about GI tract health. Plus, the Fecal Blood Test can help differentiate foregut from hindgut issues.

The SUCCEED FBT is a two-part lateral-flow assay that utilizes proprietary antibodies to specific blood proteins. Test A detects occult albumin and Test H detects equine hemoglobin in a fecal sample. Use in conjunction with history, physical examination, blood work and other diagnostic indicators, the FBT can support the practitioner’s differential diagnosis of GI health conditions in horses, including gastric and colonic ulcers.

The Reality of Equine Ulcers

Most veterinarians are familiar with Equine Gastric Ulcer Syndrome (EGUS) which manifests primarily as lesions in the distal esophagus, the squamous area of the stomach and the proximal duodenum. Gastric ulcers can be visualized with a three-meter endoscope. However, the gastric area represents less than 10% of the equine GI tract.

By contrast, equine digestion is dominated by hindgut action, but ulcers there are much harder to observe. Colonoscopies are impractical due to the difficulty of evacuating the equine colon without endangering the health of the horse. As a consequence, equine practitioners are generally less familiar with colonic ulcers.

However, it is now known that colonic ulcers are common in horses.

The ability to accurately diagnose colonic ulcers and differentiate them from stomach ulceration is of particular importance since the treatment protocols are quite different. At the very least, treatments targeting stomach ulcers are likely to have little or no effect on conditions in the hindgut.

The SUCCEED FBT is an important tool in the veterinarian’s arsenal, providing a source of objective data to support the differential diagnosis of GI tract conditions including gastric and colonic ulcers.

Using Antibodies to Detect Blood Protein Markers

To detect and potentially localize equine ulcers, we undertook an analysis of two potential marker proteins found in blood that we hoped could distinguish foregut from hindgut lesions: albumin and hemoglobin. In an experiment conducted with researchers from Island Whirl Equine Colic Research Laboratory in Florida, equine blood was introduced through a gastric cannula to two experimental horses and fecal samples were then taken periodically for the subsequent 18 hours.

These two protein markers were analyzed using an Enzyme-Linked ImmunoSorbent Assay (ELISA). When the results were plotted, we saw that the levels of hemoglobin peaked and then slowly fell over the 18-hour period, while albumin levels remained consistently low due to the gastric source of the serum. This provided strong support for the utility of these two markers in a differential diagnosis.

From this experiment, we determined that albumin could serve as a proxy for hindgut lesions, while the stability of hemoglobin should allow its use as an indicator of either foregut or hindgut lesions.

For more information, download the Antibody Study (PDF).

horse-vet

The SUCCEED® FBT – An Accurate Diagnostic Aid

The latest iteration of our antibody test kit, called the SUCCEED Equine Fecal Blood Test (FBT), is in the form of a two-part wicking rapid-test specific to equine blood proteins.

There are two wells in the kit, one to detect albumin and one for hemoglobin.

Against a fecal background, the sensitivity of the test is 0.8 parts per million (ppm) for albumin and 0.8 ppm for hemoglobin, based on whole blood equivalents. The upper limit for both is approximately 10,000 ppm, with the albumin antibodies likely exceeding this, and the hemoglobin antibodies likely falling just short of this level.
SFBT Jar and Cassette
FBT test results were compared to anatomical dissections of the stomachs and colons from 178 equine subjects post-mortem to assess the test’s predictive value.

  • For albumin, the antibody test was correlated exclusively to the level of colonic ulceration, where the cutoff was set to grade 1 and above.
  • For hemoglobin, the test correlated well to the overall level of observed GI ulceration when the positive gastric and colonic cutoff was set to grade 2 and above.
Following are the results of the study representing the accuracy and reliability of the current SUCCEED FBT:

Analysis of Tests A and H as indicators of ulceration
True Positives 166154
True Negatives311
False Positives85
False Negatives18
Sensitivity99.4%95.1%
Specificity27.3%68.8%
Positive Predictive Value95.4%96.9%
Negative Predictive Value75.0%57.9%
P-value.045.028

Downloads

fbt research brochure

The Research and Development
Behind the FBT

Download PDF

The SUCCEED Equine Fecal Blood Test is available to purchase through veterinary supply distributors. Where to buy in your country.