Uroperitoneum in the hospitalised equine neonate: retrospective study of 31 cases, 1988-1997.
Authors: Kablack K A, Embertson R M, Bernard W V, Bramlage L R, Hance S, Reimer J M, Barton M H
Journal: Equine veterinary journal
Summary
Uroperitoneum in neonatal foals presents a diagnostic challenge that extends beyond the classic electrolyte derangements traditionally taught, as this 10-year retrospective analysis of 31 hospitalised cases demonstrated that fewer than half displayed the expected hyperkalaemia, hypernatraemia and hyperchloraemia. The research team reviewed clinical, diagnostic and outcome data to establish which factors most significantly influenced survival, revealing that underlying septicaemia or severe systemic illness—identified in approximately 50% of affected foals—was a crucial prognostic indicator regardless of aetiology. Paradoxically, foals receiving fluid therapy were more likely to show both sepsis and normalised electrolyte concentrations, suggesting that aggressive resuscitation may mask biochemical markers whilst the underlying infection remains problematic. Ultrasonographic imaging, serum creatinine and the serum-to-peritoneal creatinine ratio proved reliably diagnostic even in septic patients with multisystemic disease, making these non-electrolyte-dependent tools essential for practitioners when conventional laboratory markers prove equivocal. For clinicians managing neonatal colic and suspected urinary tract rupture, this work highlights the importance of investigating concurrent sepsis as a major determinant of outcome, and validates diagnostic protocols that remain valid even when initial fluid resuscitation has altered the clinical biochemistry landscape.
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Practical Takeaways
- •Do not rely solely on electrolyte abnormalities to diagnose uroperitoneum—use ultrasonography and creatinine ratios as more reliable diagnostic tools even in septic neonates
- •Assess sepsis status carefully in foals with uroperitoneum, as concurrent septicaemia significantly impacts prognosis and treatment outcomes
- •Prior fluid therapy does not compromise diagnostic accuracy of ultrasound or creatinine-based diagnostics, so diagnostic testing remains valid in treated cases
Key Findings
- •No gender predilection observed in 31 equine neonates with uroperitoneum
- •Classic electrolyte abnormalities present in less than 50% of cases despite uroperitoneum diagnosis
- •Approximately 50% of foals with uroperitoneum had positive sepsis scores, indicating septicaemia as a crucial outcome factor
- •Ultrasonographic findings and serum creatinine ratios remained diagnostically valuable even in presence of multisystemic disease and previous fluid therapy