Surgical management and long-term outcome of umbilical infection in 65 foals (2010-2015).
Authors: Oreff Gil L, Tatz Amos J, Dahan Roee, Segev Gilad, Berlin Dalia, Kelmer Gal
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Surgical Management of Umbilical Infection in Foals Umbilical infections represent a significant clinical challenge in neonatal foals, accounting for over 17% of hospital admissions in this study of 65 cases treated surgically between 2010 and 2015. The retrospective analysis examined short-term (hospital discharge) and long-term (12-month) survival outcomes alongside clinical variables predicting prognosis, with chi-square and Fisher's exact tests identifying statistically significant associations. Overall outcomes were encouraging—77% of foals were discharged from hospital and 66% survived to one year—though survival rates diminished substantially in foals presenting at younger ages, those with concurrent septic arthritis or multiple pathologies, elevated creatinine and heart rate, and those requiring extended hospitalisation or delayed surgical intervention. Urachal enlargement and right arterial enlargement were the most commonly identified surgical findings. For practitioners, these results underscore the critical importance of early diagnosis (ideally before referral) and prompt surgical intervention; postponing surgery or managing cases with systemic signs conservatively significantly compromised outcomes, particularly in very young neonates with concurrent complications.
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Practical Takeaways
- •Early diagnosis and prompt surgical intervention for umbilical infections significantly improve survival outcomes — refer suspected cases immediately rather than attempting medical management alone
- •Poor prognostic indicators (young age, septic joints, multiple organ involvement, elevated kidney markers, high heart rate) should guide realistic client counselling about treatment expectations and costs
- •Post-operative monitoring for complications is critical as these were associated with lower long-term survival rates; expect hospitalization times may be prolonged in complicated cases
Key Findings
- •Short-term survival (hospital discharge) was 77% (50/65 foals) and long-term survival at 1 year was 66% (43/65 foals)
- •Poor prognostic factors included younger age at presentation, septic joints, multiple concurrent pathologies, elevated creatinine, tachycardia, and delayed surgery
- •Foals diagnosed prior to hospital referral had better outcomes than those diagnosed after admission
- •Urachal enlargement was the most common surgical finding, followed by right arterial enlargement