supplementation by bottle or stomach tube.
Colostrometer reading%
Conc. IgG g/l
Colostrum quality
<10-15
0-25
Poor
15-20
28-45
Borderline
20-30
45-80
Good
>30
>80
excellent
Inflammatory Proteins – the acute phase reactive proteins fibrinogen and
serum amyloid A (SAA) are elevated in cases of inflammation/infection.
Fibrinogen rises and falls more slowly than SAA. Elevated fibrinogen at birth
indicates in utero pathology. Normal fibrinogen range increases over first few
months (from 2 to 4g/l) although in the author’s opinion fibrinogen values> 3g/l
indicate a problem. SAA increases rapidly in cases of bacterial infection, less
so in inflammation. Levels decrease rapidly in response to appropriate
treatment so it is a very useful marker in monitoring response to treatment.
Automated assays for fibrinogen are available, with the direct coagulometric
assay being the most accurate. This requires blood to be collected into blue
top CITRATE tubes. Fibrinogen can be estimated in practice using a 56ºC
denaturation method described below:
Measure EDTA plasma protein using a refractometer and note value (x).
Incubate a small (2ml) sample for 5 minutes in a 56ºC waterbath.
Centrifuge sample and remeasure protein level using refractometer and note
value (y).
The fibrinogen is denatured and x-y equals the fibrinogen level.
This method will only give accurate values up to 6g/l. If fibrinogen values are
over 6g/l, repeat values cannot be used to monitor a trend, as accuracy is
unknown, therefore the actual fibrinogen value is unknown.
Albumin – falls with disease – consider protein binding of drugs when treating
sick neonates – care with dose-rates.
Creatinine kinase (CK) – increased with recumbency, convulsions, white
muscle disease (selenium deficiency) and other causes of foal
rhabdomyolysis.
Alkaline phosphatase (ALP) – elevated at birth due to high isoenzymes from
bone and gut so not very useful in assessing liver function in neonate.
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
199