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Short-term outcome and risk factors for post-operative complications following umbilical resection in 82 foals

L Reig Codina¹, S R Werre², J A Brown¹

¹Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, Virginia, USA.

Equine Veterinary Journal

|September 15, 2018

Abstract

Background:

Umbilical remnant infection and patent urachus are an important cause of morbidity for the equine neonate. Left untreated, fatal complications can develop. Identifying risk factors for post-operative complications after surgery are important for estimating prognosis.

Objectives:

To identify risk factors associated with post-operative complications in foals undergoing umbilical remnant resection due to patent and/or infected umbilical remnants.

Study Design:

Retrospective case series.

Methods:

Foals undergoing umbilical remnant resection due to patent urachus or infected remnants at the Marion duPont Scott Equine Medical Center from 2004 to 2016 were included in the study. Data were obtained from medical records and associations between outcomes and post-operative complications, and pre or intraoperative clinical variables were assessed using bivariable and multivariable analyses.

Results:

Eighty-two foals underwent umbilical remnant resection of which 73 (89.0%) survived to discharge. The urachus was the most commonly affected structure being patent and/or infected in 84.1% of cases. Concurrent diseases were present in 60.6% of foals prior to surgery, with diarrhoea and septic arthritis being most common. The presence of preoperative septic arthritis and/or physitis were significantly associated with nonsurvival (OR 33; 95% confidence interval 1.1-985.2; P = 0.04). Longer anaesthesia time (OR 1.4; 95% confidence interval 1.1-1.7; P = 0.02) and failure of passive transfer of immunoglobulins (OR 5.9; 95% confidence interval 1.2-29.04; P = 0.03) were associated with increased odds for post-operative complications.

Main Limitations:

It is not known if medical treatment alone would have been successful in foals that did not receive preoperative medical treatment.

Conclusions:

Overall survival is high after surgical excision of umbilical remnants. The presence of preoperative septic arthritis and/or physitis was associated with decreased survival and failure of passive transfer of immunoglobulins and longer anaesthesia times were associated with increased odds for post-operative complications.

Keywords:

foal horse infection omphalectomy patency umbilicus

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