Short-term outcome and risk factors for post-operative complications following umbilical resection in 82 foals (2004-2016).
Authors: Reig Codina L, Werre S R, Brown J A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Umbilical Remnant Resection in Foals Umbilical remnant disease—particularly patent urachus and infection—remains a significant source of neonatal morbidity in horses, yet evidence on surgical outcomes and prognostic factors has been limited. Codina and colleagues reviewed 82 foals that underwent umbilical remnant resection between 2004 and 2016, using multivariable analysis to identify risk factors for post-operative complications and mortality. The urachus was involved in 84.1% of cases, and whilst overall survival to discharge was encouraging at 89%, foals presenting with pre-operative septic arthritis and/or physitis faced substantially worse prognosis (33-fold increased odds of non-survival). Beyond this major risk factor, failure of passive transfer of immunoglobulins and prolonged anaesthesia times independently increased the likelihood of post-operative complications. For equine practitioners, these findings underscore the importance of thorough pre-operative assessment—particularly immunoglobulin status and joint involvement—when counselling on prognosis, and suggest that minimising surgical time where possible may improve outcomes even in apparently uncomplicated cases.
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Practical Takeaways
- •Surgical excision of infected or patent umbilical remnants has good outcomes (89% survival), but foals with concurrent septic arthritis/physitis require careful prognostic counseling due to significantly worse survival
- •Minimize anaesthesia time and optimize passive transfer status preoperatively to reduce post-operative complication risk
- •Be alert for concurrent infectious conditions (present in 60.6% of cases) before surgery, particularly diarrhoea and joint/bone infections, as these substantially impact prognosis
Key Findings
- •89.0% (73/82) of foals survived to discharge following umbilical remnant resection
- •Preoperative septic arthritis and/or physitis were significantly associated with nonsurvival (OR 33; P = 0.04)
- •Longer anaesthesia time was associated with increased odds for post-operative complications (OR 1.4; P = 0.02)
- •Failure of passive transfer of immunoglobulins was associated with increased odds for post-operative complications (OR 5.9; P = 0.03)