Evaluation of refractometry methods for estimating passive immunity status in neonatal foals

The objective of this cross-sectional study was to determine the accuracy of the digital Brix and serum total protein (TP) refractometers for estimating different passive immunity status in neonatal foals. In total, 18- to 40-h old purebred Arabian foals (n = 185) were used. Serum TP concentrations, total solid percentages and IgG concentrations were measured with a digital serum TP refractometer, digital Brix refractometer and the gold standard radial immunodiffusion (RID) assay, respectively. Correlation coefficients were calculated between the refractometer and RID assay results. A receiver operating characteristic analysis was used to select the optimal cut-offs for both refractometers. Test performance and agreement were evaluated using diagnostic test characteristics at optimal thresholds and areas under the ROC curve, and by calculating Cohen's kappa coefficient. The sensitivity and specificity of the digital Brix refractometer at optimal cut-offs (≤7.8%, ≤7.9%, ≤8.2%, ≤8.3%, ≤9.0%) were 100 and 69.3%; 100% and 68.5%; 70.5% and 71.0%; 88.3% and 85.5%; 88.1% and 76% to estimate RID-IgG of <400 mg/dL, <800 mg/dL, <1500 mg/dL, <2500 mg/dL and < 3000 mg/dL, respectively. The sensitivity and specificity of the digital serum TP refractometer at optimal cut-off (≤4.6 g/dL, ≤4.6 g/dL, ≤4.8 g/dL, ≤5.0 g/dL, ≤5.4 g/dL) were 100 and 69.3%; 100% and 72.8%; 90% and 72.8%; 72.9% and 83.9%; 84.4% and 88% to estimate RID-IgG of <400 mg/dL, <800 mg/dL, <1500 mg/dL, <2500 mg/dL and < 3000 mg/dL, respectively. In conclusion, the refractometers showed a good potential as screening tools for the estimation of different IgG concentrations in neonatal foals.