Exploratory celiotomy for suspected urinary tract disruption in neonatal foals: a review of 18 cases.

The research article discusses a study on 18 neonatal foals who underwent exploratory celiotomy for suspected urinary tract disruptions, revealing that despite clinical signs not all had a physical leak present. The study also emphasizes the application of ultrasonography as a diagnostic tool and highlights that around half of the foals survived after six months, with the majority of the non-survivors succumbing to infections.

Objective and Methodology

• The study was carried out on 18 neonatal horses (foals) that were suspected to have urinary tract disruptions. The presence of such disruptions was estimated based on clinical signs and laboratory values.
• The method used for inspection in this case was exploratory celiotomy, which is a surgical incision into the abdominal cavity to examine internal organs and identify possible abnormalities.
• For pre-operative diagnosis, ultrasonography was used on eight of the foals to check for the presence of free peritoneal fluid and to inspect the integrity of the urinary tract.

Results and Observations

• Despite the clinical signs and laboratory values indicative of potential urinary tract leakage, three foals did not show any evidence of such a condition during surgery.
• Eight foals had ruptured bladders and seven foals had damage to their urachus, which is a fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that is usually obliterated after birth.
• Nine foals survived and were alive six months after their discharge from the veterinary hospital.

Conclusion and Future Implications

• Of the nine foals that did not survive, seven died or were euthanized due to severe fungal or bacterial infections, suggesting that the foals’ condition may have made them more susceptible to infection, and highlighting the challenge of managing infections in such cases.
• This study stresses the importance of imaging diagnostics, such as ultrasonography, in identifying urinary tract lesions in neonatal foals before carrying out invasive procedures like exploratory celiotomy.
• The authors recommend further research to improve diagnostic accuracy and explore better post-surgery care to increase the survival rates in foals with urinary tract disruptions.