{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:00:19Z","timestamp":1790974819851,"version":"4.1.0"},"reference-count":52,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Animals"],"abstract":"<jats:p>The traditional veterinary classification (TVC) of effusions based on cell count and total protein (TP) does not adequately reflect the aetiology. Light\u2019s criteria (LC) (activity of lactate dehydrogenase [LDH] in the effusion [LDHef], effusion\/serum LDH ratio [LDHr], effusion\/serum TP ratio [TPr]), serum\u2013effusion albumin gradient (ALBg), acute phase proteins (APPs) [serum amyloid A (SAA), \u03b11-acid glycoprotein (AGP), haptoglobin] might aid classification. The aim was to evaluate the utility of these parameters except LDHr in differentiating exudates from transudates. Sixty-five cats with effusions (33 peritoneal, 31 pleural, 1 pericardial), with 18 transudates and 47 exudates based on aetiological classification (AC), were included. The sensitivity, specificity and accuracy of several parameters to identify exudates (based on AC) was assessed. APPs were compared between exudates and transudates based on AC and TVC, with receiver operating characteristics analysis identifying the best APP to recognise exudates. Simplified LC (LDHef, TPr) had an accuracy of 79% and TVC of 48%. ALBg had the highest sensitivity (98%) and LDHef the highest specificity (83%) in identifying exudates in cats. All APPs but effusion SAA could differentiate exudates from transudates based on AC (effusion AGP had the largest area under the curve 0.79) but not TVC. All parameters were better than TVC in identifying exudates. The conformity of APPs with AC but not TVC favours the use of AC to classify effusions.<\/jats:p>","DOI":"10.3390\/ani13121918","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T01:32:34Z","timestamp":1686274354000},"page":"1918","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Simplified Light\u2019s Criteria and Acute Phase Proteins Reflect Aetiology of Feline Body Cavity Effusions Better than the Traditional Classification Scheme"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7185-0446","authenticated-orcid":false,"given":"Katarina","family":"Hazuchova","sequence":"first","affiliation":[{"name":"Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University of Giessen, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Held","sequence":"additional","affiliation":[{"name":"Tierarztpraxis an der Erft, 50127 Bergheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabell","family":"Klemm","sequence":"additional","affiliation":[{"name":"Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University of Giessen, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natali","family":"Bauer","sequence":"additional","affiliation":[{"name":"Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University of Giessen, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"ref_1","unstructured":"Valenciano, A., and Cowell, R. (2020). Cowell and Tyler\u2019s Diagnostic Cytology and Hematology of the Dog and Cat, Mosby. [5th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.jfms.2010.07.013","article-title":"Pleural effusion in the cat","volume":"12","author":"Beatty","year":"2010","journal-title":"J. Feline Med. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1177\/1098612X18816489","article-title":"Retrospective analysis of pleural effusion in cats","volume":"21","author":"Hartmann","year":"2019","journal-title":"J. Feline Med. Surg."},{"key":"ref_4","unstructured":"Ettinger, S.J., Feldman, E.C., and Cote, E. (2017). Textbook of Veterinary Internal Medicine: Diseases of the Dog and the Cat, Elsevier. [8th ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.tvjl.2014.04.016","article-title":"An update on feline infectious peritonitis: Diagnostics and therapeutics","volume":"201","author":"Pedersen","year":"2014","journal-title":"Vet. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.jfms.2009.04.005","article-title":"A new approach to pleural effusion in cats: Markers for distinguishing transudates from exudates","volume":"11","author":"Zoia","year":"2009","journal-title":"J. Feline Med. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1177\/1098612X15592170","article-title":"Diagnostic value of Light\u2019s criteria and albumin gradient in classifying the pathophysiology of pleural effusion formation in cats","volume":"18","author":"Zoia","year":"2016","journal-title":"J. Feline Med. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"507","DOI":"10.7326\/0003-4819-77-4-507","article-title":"Pleural effusions: The diagnostic separation of transudates and exudates","volume":"77","author":"Light","year":"1972","journal-title":"Ann. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1378\/chest.111.4.970","article-title":"Diagnostic value of tests that discriminate between exudative and transudative pleural effusions","volume":"111","author":"Heffner","year":"1997","journal-title":"Chest"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1111\/j.1440-1843.2012.02155.x","article-title":"Solving the Light\u2019s criteria misclassification rate of cardiac and hepatic transudates","volume":"17","author":"Bielsa","year":"2012","journal-title":"Respirology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/j.1572-0241.1998.00401.x","article-title":"Ascitic fluid to serum bilirubin concentration ratio for the classification of transudates or exudates","volume":"93","author":"Elis","year":"1998","journal-title":"Am. J. Gastroenterol."},{"key":"ref_12","first-page":"166","article-title":"The diagnostic separation of transudates and exudates in ascitic fluid and pleural fluid","volume":"53","author":"Anchinmane","year":"2011","journal-title":"Bombay Hosp. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1749-6632.1982.tb22124.x","article-title":"The Phenomenon of the Acute Phase Response","volume":"389","author":"Kushner","year":"1982","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.tvjl.2007.06.005","article-title":"The feline acute phase reaction","volume":"177","author":"Paltrinieri","year":"2008","journal-title":"Vet. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/vr.141.12.299","article-title":"Value of alpha1-acid glycoprotein in the diagnosis of feline infectious peritonitis","volume":"141","author":"Duthie","year":"1997","journal-title":"Vet. Rec."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/104063870701900306","article-title":"Critical Assessment of the Diagnostic Value of Feline \u03b11-Acid Glycoprotein for Feline Infectious Peritonitis Using the Likelihood Ratios Approach","volume":"19","author":"Paltrinieri","year":"2007","journal-title":"J. Vet. Diagn. Investig."},{"key":"ref_17","first-page":"503","article-title":"Serum alhpa 1-acid glycoprotein concentrations in healthy and tumor-bearing cats","volume":"14","author":"Selting","year":"2000","journal-title":"J. Vet. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1292\/jvms.65.545","article-title":"Evaluation of feline serum amyloid A (SAA) as an inflammatory marker","volume":"65","author":"Sasaki","year":"2003","journal-title":"J. Vet. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1111\/jvim.15704","article-title":"Prognostic value of systemic inflammatory response syndrome and serum concentrations of acute phase proteins, cholesterol, and total thyroxine in cats with panleukopenia","volume":"34","author":"Petini","year":"2020","journal-title":"J. Vet. Intern. Med."},{"key":"ref_20","unstructured":"Held, S. (2013). Genauigkeit Diagnostischer Tests F\u00fcr Feline Infekti\u00f6se Peritonitis (FIP) Bei Katzen Mit Einem K\u00f6rperh\u00f6hlenerguss. [Ph.D. Thesis, Justus-Liebig-Universit\u00e4t]."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Carvalho, J., Lesot, M., Kaymak, U., Vieira, S., Bouchon-Meunier, B., and Yager, R. (2016). Information Processing and Management of Uncertainty in Knowledge-Based Systems, Proceedings of the IPMU 2016, Communications in Computer and Information Science, Springer International Publishing.","DOI":"10.1007\/978-3-319-40581-0"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1177\/1098612X16658925","article-title":"Usefulness of acute phase proteins in differentiating between feline infectious peritonitis and other diseases in cats with body cavity effusions","volume":"19","author":"Hazuchova","year":"2017","journal-title":"J. Feline Med. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1111\/jvim.15745","article-title":"ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats","volume":"34","author":"Abbott","year":"2020","journal-title":"J. Vet. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S1090-0233(03)00055-8","article-title":"Changes in some acute phase protein and immunoglobulin concentrations in cats affected by feline infectious peritonitis or exposed to feline coronavirus infection","volume":"167","author":"Giordano","year":"2004","journal-title":"Vet. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/j.1748-5827.2011.01042.x","article-title":"Performances of different diagnostic tests for feline infectious peritonitis in challenging clinical cases","volume":"52","author":"Giori","year":"2011","journal-title":"J. Small Anim. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.tvjl.2005.04.021","article-title":"Evaluation of a commercially available human serum amyloid A (SAA) turbidometric immunoassay for determination of equine SAA concentrations","volume":"172","author":"Jacobsen","year":"2006","journal-title":"Vet. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1292\/jvms.70.1247","article-title":"Verification of measurement of the feline serum amyloid A (SAA) concentration by human SAA turbidimetric immunoassay and its clinical application","volume":"70","author":"Tamamoto","year":"2008","journal-title":"J. Vet. Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.cll.2010.10.002","article-title":"Assay validation and diagnostic applications of major acute-phase protein testing in companion animals","volume":"31","author":"Jacobsen","year":"2011","journal-title":"Clin. Lab. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.cccn.2004.02.002","article-title":"Biochemical analysis of pleural, peritoneal and pericardial effusions","volume":"343","author":"Burgess","year":"2004","journal-title":"Clin. Chim. Acta"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"886","DOI":"10.2460\/javma.253.7.886","article-title":"Incidence of chyloabdomen diagnosis in dogs and cats and corresponding clinical signs, clinicopathologic test results, and outcomes: 53 cases (1984\u20132014)","volume":"253","author":"Hatch","year":"2018","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1378\/chest.07-2232","article-title":"Pleural fluid analysis in chylous pleural effusion","volume":"133","author":"Agrawal","year":"2008","journal-title":"Chest"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1378\/chest.109.6.1503","article-title":"A study of Light\u2019s criteria and possible modifications for distinguishing exudative from transudative pleural effusions","volume":"109","author":"Vives","year":"1996","journal-title":"Chest"},{"key":"ref_33","unstructured":"Stockham, S.L., and Scott, M.A. (2008). Fundamentals of Veterinary Clinical Pathology, Blackwell Publishing. [2nd ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","article-title":"Meaning and and use of of the the area under a receiver operating curve","volume":"143","author":"Hanley","year":"1982","journal-title":"Radiology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1148\/radiology.148.3.6878708","article-title":"A method of comparing the areas under receiver operating characteristic curves derived from the same cases","volume":"148","author":"Hanley","year":"1983","journal-title":"Radiology"},{"key":"ref_36","unstructured":"Cohen, J. (1998). Statistical Power Analysis for the Behavioral Sciences, Routledge. [2nd ed.]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Faul","year":"2009","journal-title":"Behav. Res. Methods"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5326\/JAAHA-MS-5558","article-title":"A review of the pathophysiology, classification, and analysis of canine and feline cavitary effusions","volume":"47","author":"Dempsey","year":"2011","journal-title":"J. Am. Anim. Hosp. Assoc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s00580-013-1684-x","article-title":"Effusion in the cat: Classification of 396 fluids according to a problem-oriented scheme","volume":"22","author":"Gavazza","year":"2013","journal-title":"Comp. Clin. Path."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ccm.2012.11.006","article-title":"The Light Criteria: The Beginning and Why they are Useful 40 Years Later","volume":"34","author":"Light","year":"2013","journal-title":"Clin. Chest Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1001\/archinte.1978.03630320041014","article-title":"Diagnostic Value of Ascitic Fluid Lactic Dehydrogenase, Protein, and WBC Levels","volume":"138","author":"Boyer","year":"1978","journal-title":"Arch. Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1378\/chest.107.6.1604","article-title":"Comparative analysis of the biochemical parameters used to distinguish between pleural transudates and exudates","volume":"107","author":"Burgess","year":"1995","journal-title":"Chest"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00580-021-03280-7","article-title":"Retrospective study of the aetiopathological diagnosis of pleural or peritoneal effusion exams of dogs and cats","volume":"30","author":"Engelmann","year":"2021","journal-title":"Comp. Clin. Path."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3390\/diagnostics11112003","article-title":"Role of c-reactive protein in discrimination between transudative and exudative pleural effusions","volume":"11","author":"Kogan","year":"2021","journal-title":"Diagnostics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"047297","DOI":"10.1155\/MI\/2006\/47297","article-title":"The acute-phase proteins serum amyloid A and C reactive protein in transudates and exudates","volume":"2006","author":"Okino","year":"2006","journal-title":"Mediat. Inflamm."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1159\/000029459","article-title":"Significance of alpha-2-macroglobulin, alpha-1-acid glycoprotein, and C-reactive protein in pleural effusion differentiation","volume":"67","author":"Alexandrakis","year":"2000","journal-title":"Respiration"},{"key":"ref_48","first-page":"122","article-title":"Use of acute phase proteins in pleural effusion discrimination","volume":"52","author":"Calikoglu","year":"2004","journal-title":"Tuberk. Toraks"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/0970-2113.148419","article-title":"Use of pleural fluid ceruloplasmin in the differentiation of exudative and transudative pleural effusion","volume":"32","author":"Shanthaveeranna","year":"2015","journal-title":"Lung India"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1177\/1040638713486112","article-title":"Serum amyloid A as a prognostic marker in cats with various diseases","volume":"25","author":"Tamamoto","year":"2013","journal-title":"J. Vet. Diagn. Investig."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1098612X231162836","DOI":"10.1177\/1098612X231162836","article-title":"Cat alpha-1-acid glycoprotein enzyme-linked immunosorbent assay: Performance characteristics and reference intervals","volume":"25","author":"Thalmeier","year":"2023","journal-title":"J. Feline Med. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Jacobsen, S., Vinther, A.M., Kjelgaard-Hansen, M., and Nielsen, L.N. (2019). Validation of an equine serum amyloid A assay with an unusually broad working range. BMC Vet. Res., 15.","DOI":"10.1186\/s12917-019-2211-3"}],"container-title":["Animals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2615\/13\/12\/1918\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:51:01Z","timestamp":1760125861000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2615\/13\/12\/1918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,8]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["ani13121918"],"URL":"https:\/\/doi.org\/10.3390\/ani13121918","relation":{},"ISSN":["2076-2615"],"issn-type":[{"value":"2076-2615","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,8]]}}}