Uroperitoneum in 32 foals: influence of intravenous fluid therapy, infection, and sepsis.
Authors: Dunkel Bettina, Palmer Jonathan E, Olson Kim N, Boston Ray C, Wilkins Pamela A
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Uroperitoneum in Foals Uroperitoneum presents a common surgical emergency in neonatal foals, yet the underlying pathophysiology and risk factors remain incompletely understood. Dunkel and colleagues retrospectively examined 32 foals with uroperitoneum, stratifying them by presentation type (referred with suspected uroperitoneum versus developing it whilst hospitalised) to identify differences in clinical presentation, electrolyte status, infection markers, and anaesthetic complications during surgical repair. Foals developing uroperitoneum in-hospital typically had histories of dystocia and presented within 48 hours of birth with signs of intrauterine compromise or presumed hypoxic–ischaemic injury; those referred with suspected uroperitoneum often had concurrent systemic problems and demonstrated classical electrolyte derangements (hyponatraemia and hyperkalaemia) on arrival, whereas foals receiving balanced intravenous fluids developed less obvious electrolyte patterns despite comparable elevations in serum creatinine and oliguria. Infection was present in 63% of cases with 78% showing septic signs, implicating intrauterine insult and secondary infection as major predisposing factors. Critically, anaesthetic complications occurred in 16% of surgical cases, though only half of these foals presented with hyperkalaemia, suggesting additional mechanisms beyond electrolyte disturbance may contribute to perioperative risk—a finding relevant to your pre-operative assessment protocols and intravenous fluid selection during management of neonatal emergencies.
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Practical Takeaways
- •Foals with uroperitoneum have high infection/sepsis rates (78%); aggressive antimicrobial therapy and sepsis management are critical components of treatment beyond surgical repair alone
- •In neonates presenting with dystocia history and early signs of compromise, uroperitoneum should remain on the differential diagnosis list as intrauterine insult and sepsis predispose to this condition
- •Use balanced electrolyte solutions for IV fluid therapy in affected foals—they prevent the severe electrolyte abnormalities that increase anesthetic risk, though monitoring creatinine and urine output remains essential
Key Findings
- •63% of foals with uroperitoneum had confirmed infection, and 78% showed signs of sepsis or infection
- •Foals developing uroperitoneum in-hospital presented at <48 hours of age following dystocia with signs of hypoxic or ischemic insult
- •Foals receiving balanced intravenous fluid therapy did not develop classical hyperkalemia/hyponatremia pattern but still developed elevated serum creatinine and decreased urine production
- •Anesthetic complications occurred in 16% of foals undergoing surgical repair, though hyperkalemia was present in only half of these cases