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Posted by: admin on Jul 22, 2010 - 10:06 AM
equinehealth
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Foals can be affected by omphalitis (infection/inflammation of the umbilical structures) which can be due to inflammation of the umbilical arteries, umbilical vein, urachus, or tissues surrounding the umbilicus. Omphalophlebitis is infection of the umbilical vessels. The urachus is a structure that in utero transports fetal urine from the fetal bladder to the placenta. It normally will close at birth, but can become infected and/or inflamed in neonatal foals. After birth, blood flow no longer occurs in the umbilical arteries and vein, and they become ligaments in the abdomen. These structures can each serve as areas of infection. Umbilical remnant infections have been referred to in the past as “navel ill”.
There are some predisposing factors that can put a foal at greater risk of developing an infected umbilical remnant due to infection spreading to the umbilicus or associated vessels such as a foal with failure of passive transfer (lack of intake of colostrum). Healthy foals can also develop local infections of their umbilical remnants, and this is one of the reasons why it is very important to clean the umbilicus with diluted chlorhexidine or dilute betadine solution in neonatal foals.
Clinical signs important to watch for in the cases of omphalitis/phlebitis depend on whether the infection is due to a systemic infection or due to a local infection.
• Local: umbilical swelling, purulent (pus-like) discharge, swelling along the lower abdomen, pain, and/or heat around the umbilicus.
• Systemic (septic): fever (greater than 102.5 F), depression, recumbency, inappetance/loss of suckle, signs associated with systemic infection (increased respiration, difficulty breathing, diarrhea, colic, swollen joints, lameness), along with general clinical signs associated with a local umbilical infection.
Treatment options for umbilical remnant infections consist of medical and/or surgical therapy. Your veterinarian can perform a physical exam, bloodwork, and possibly an ultrasound examination to determine the extent of infection.
•Medical: This is preferable in small, localized infections in foals that are not good anesthetic candidates. Treatment includes broad spectrum antibiotics (2-3 week duration at times), with frequent re-evaluation through assessing vital signs (temperature, pulse, respiration, general demeanor), bloodwork values (especially fibrinogen) and ultrasonographic exams of the umbilical remnants. If there is no improvement within 7-10 days, a change in antibiotics is recommended; however, surgical intervention to remove the entire remnant may be necessary if the foal does not respond to medical therapy.
•Surgical: This is the most definitive and is the standard treatment.
A foal with a systemic illness (septicemia) should be stabilized prior to surgery, but complete removal of the infected remnant is essential so as to prevent future seeding of the remnant and other parts of the body (joints, lungs, GI) with infection. The entire remnant is removed including the arteries up to the level of the bladder and the vein extending to the level of the liver. Bacterial culture should be performed on the stump to direct appropriate antibiotic treatment.
When caring for a foal, it is important to contact your veterinarian at the first signs of a depressed attitude, lethargy, changes in eating, fever, colic, cough, lameness, swelling, discharge, or heat around the umbilicus, or any signs of discomfort in your foal. We recommend a routine foal check at 24 hours of age. Your veterinarian can assess the foal’s overall health and condition and determine if the foal has any predisposing factors for infection. An IgG level should be checked at this time. Umbilical infections are one of the primary sites of infection in a foal that does not have an IgG level of greater than 800.
If you have any questions regarding foal care and health or specific questions about umbilical infections, please contact your veterinarian or any of the veterinarians at New England Equine Medical & Surgical Center.
Kate Britton, DVM
Jacqueline Bartol, DVM, DACVIM
www.newenglandequine.com
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