Use InstrUCtIons and
teChnICal InforMatIon
SUCCEED
®
and Digestive Conditioning Program
®
are registered trademarks, and Equine Fecal Blood Test™
is a trademark of Freedom Health LLC © 2012. All Rights Reserved.
SUCCEED
®
Digestive Conditioning Program
®
holds U.S. Patent Nos. 7,658,964; 7,824,706 and 7,988,989.
Further patents pending.
SUCCEED
®
Equine Fecal Blood Test™ holds U.S. Patent No. 7,629,180.
Equine GI lesions – including petechiation and parasite pits –
may bleed lightly or intermittently, so a test result may be negative
even when disease is present. And because blood components may be
non-uniformly distributed in a fecal dropping, negative readings may
occasionally be obtained from a fecal sample of an unhealthy horse.
As with any fecal blood test, SUCCEED FBT is not a conclusive
diagnostic for occult gastrointestinal bleeding or pathology; it should
be employed only as an aid to diagnosis.
Additionally, a positive test result (especially Test H),
can arise from extraneous sources, such as:
• Dentistry or exercise-induced pulmonary hemorrhage
• Mare ovulation
• Post-surgery bleeding
As with any diagnostic, a definitive diagnosis should not be based on
the result of a single test. The test is designed to be complementary
to blood tests and physical examination. NOTE: Practitioners
experiencing a positive Test A without a positive Test H, should include
a protein-losing enteropathy as one differential diagnosis, especially
in the presence of hypoproteinemia/hypoalbuminemia on a CBC/chem
profile. A negative test result in conjunction with hypoproteinemia/
hypoalbuminemia may reflect a protein-losing nephropathy.
aPPlICatIons
Because symptoms are an unreliable indicator of GI health,
practitioners should test horses periodically. Given the ease and
affordability of the FBT, testing all horses on a regular schedule is a
practical option for early detection.
Consistent testing is especially important for performance horses,
or wherever the care, feeding and general husbandry can affect
digestive health, including intermittent feeding, high-grain diets, stall
confinement, etc. Because it is possible that GI health may be a root
cause of many performance or behavioral problems, horses with such
issues may be prime candidates for testing.
The SUCCEED FBT may also be a valuable part of a pre-purchase
exam.
®
I
501 Rev H 04/12
2
Freedom Health, LLC
65 Aurora Industrial Parkway
Aurora, OH 44
20
2
Toll-free service line:
877-73
4-65
58
24 hours a day
For more information,
visit our website at
www.SucceedFB
T.com
Contact Information:
SUCCEED
®
Digestive Conditioning Program
®
Veterinary Formula.
Also available from Freedom Health:
InterPretIng the resUlts
The following chart summarizes the meaning of positive and/or
negative test results across SUCCEED FBT tests A and H.
* Note that Test A uses an antibody for albumin, which typically
breaks down in digestion, particularly when exposed to digestive
enzymes in the proximal portion of the small intestine. Thus a
positive Test A will indicate bleeding from a source caudal to the
duodenum (e.g. hindgut). Also, because albumin may be present
at the site of low-grade injury absent whole blood, you may get a
positive Test A in response to a low-grade lesion in the hindgut,
such as may occur with heavy parasitism or disseminated grade 1
colonic ulcers.
Test H uses an antibody for hemoglobin, which is more resistant
to enzymatic activity. Thus a positive Test H, with negative Test
A, will indicate occult blood from a foregut source. You will not
obtain a positive result from either Test A or H when a horse has a
foregut lesion equivalent to a grade 1 gastric ulcer, where whole
blood loss does not occur.
lIMItatIons of the test
The SUCCEED FBT is a fecal occult blood test. It is designed
to detect blood components in feces that may be indicative of
underlying pathologic conditions. This makes the SUCCEED FBT a
qualitative test for the presence and location of gastrointestinal
injury. It is not a quantitative test.
Albumin may be present at the site of injury absent whole blood.
Thus a positive test A reflects injury equivalent to grade 1 or
higher ulceration in the hindgut. Hemoglobin is only present with
whole blood. Therefore, a positive test H reflects injury equivalent
to grade 2 or higher ulceration anywhere in the GI tract.
Equine albumin and hemoglobin in feces may arise from a variety
of conditions, including but not limited to:
• Bleeding ulcers (gastric or colonic)
• Excessive parasitic activity
• Protein-losing enteropathy (PLE)
• Lesions caused by hard particles of feed or
other ingested material
• Petechiation, hyperemias or lipomas
No GI tract
issue detected.
GI tract issue
detected in
hindgut.
GI tract issue
detected in
foregut.
GI tract issue
detected in
hindgut.
Foregut issue
also possible.*
Negative
Positive
P
ositive
Negative
Test A
Albumin
Test
H
Hemoglobin
PerforManCe CharaCterIstICs
analytICal sensItIvIty
The antibodies used in the two parts of the SUCCEED FBT – Test
A and Test H – were evaluated by introducing equine blood at
varying concentrations into a solution of water and rabbit fecal
matter. The detection limits of the FBT antibodies, at a 95%
confidence level, are provided here.
dIagnostIC relIabIlIty
Figure 2 indicates the statistical accuracy of the SUCCEED FBT
results as a reflection of actual pathological conditions in horses,
as determined by comparing FBT results on fecal samples from
equine subjects with observed GI tract injury in those same
subjects post-necropsy.
The SUCCEED FBT has been calibrated to detect blood
components at levels reflecting true pathologies and to ignore
subclinical or baseline bleeding.
The performance of the SUCCEED FBT was assessed with multiple
in vitro
and
in vivo
tests, with the results as detailed below.
All whole blood equivalents
Fig 1: Detection limits of FBT antibodies
Test A (Albumin)
Test H (Hemoglobin)
Lower
.8 ppm
.8 ppm
Upper
10,000+ ppm
10,000+ ppm
Fig 2: Analysis of tests A & H as indicators of ulceration
N=178
Test A (Colon)
Test H (Full GI Tract)
True Positives
166
154
True Negatives
3
11
False Positives
8
5
False Negatives
1
8
Sensitivity
99.4%
95.1%
Specificity
27.3%
68.8%
Positive Predictive
Value
95.4%
96.9%
Negative Predictive
Value
75.0%
57.9%
P-value
.045
.028
