Hematuria in a 3-month-old filly with an internal umbilical abscess and internal iliac artery aneurysm.
Abstract: A 3-month-old foal with a history of acute hematuria was evaluated. Hydronephrosis and hydroureter were visualized upon renal ultrasonography of the left kidney. Cystoscopy identified a blood clot occluding the left ureter. Computed tomography (CT) revealed a large retroperitoneal abscess at the level of the aortic bifurcation and a left internal iliac aneurysm. Due to the severity of the lesions and the poor prognosis, the filly was euthanized and the clinical findings were confirmed by post-mortem examination. This report emphasizes the value of obtaining a precise diagnosis CT in order to avoid unviable treatment approaches when confronted with this unusual secondary complication of omphaloarteritis. Key clinical message: Umbilical complications are routinely diagnosed in equine neonatal medicine, and commonly lead to septicemia, physitis, and septic arthritis; severe internal umbilical abscessation, and subsequent vascular and urinary disorders are uncommon sequelae. . Un poulain de 3 mois ayant des antécédents d’hématurie aiguë a été évalué. L’hydronéphrose et l’hydro-uretère ont été visualisés par échographie rénale du rein gauche. La cystoscopie a identifié un caillot sanguin obstruant l’uretère gauche. La tomodensitométrie (TDM) a révélé un gros abcès rétropéritonéal au niveau de la bifurcation aortique et un anévrisme iliaque interne gauche. En raison de la gravité des lésions et du mauvais pronostic, la pouliche a été euthanasiée et les résultats cliniques ont été confirmés par un examen post-mortem. Ce rapport souligne l’intérêt d’obtenir un diagnostic précis par TDM afin d’éviter des approches thérapeutiques non-viables face à cette complication secondaire inhabituelle de l’omphalo-artérite.Message clinique clé :Les complications ombilicales sont couramment diagnostiquées en néonatalogie équine et conduisent généralement à une septicémie, une épiphysite et une arthrite septique; un abcès ombilical interne sévère et des troubles vasculaires et urinaires subséquents sont des séquelles peu fréquentes.(Traduit par D Serge Messier).
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Publication Date: 2021-08-04 PubMed ID: 34341604PubMed Central: PMC8281942
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Summary
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The research article focuses on a case of a 3-month-old foal suffering from acute hematuria, which was found to be linked to an internal umbilical abscess and internal iliac artery aneurysm. The clinical findings underscore the crucial role of accurate diagnosis via computed tomography (CT) for tailoring appropriate treatments, particularly in rare secondary complications like omphaloarteritis.
Summary of the Case
- The paper reports on a 3-month-old foal which had a history of acute hematuria or blood in urine.
- The foal underwent various diagnostic procedures including renal ultrasonography of the left kidney, which revealed hydronephrosis, an abnormal enlargement of the kidney due to blockage of urine flow, and hydroureter, a condition where the ureter becomes swollen due to a buildup of urine.
- Cystoscopy, another diagnostic process, identified a blood clot blocking the left ureter, which is a tube that carries urine from the kidneys to the bladder.
Key Clinical Findings and Outcome
- A computed tomography (CT) scan revealed the presence of a large abscess within the retroperitoneal area, which is space in the abdominal cavity located behind the peritoneum. This abscess was situated at the level of the aortic bifurcation, the region where the aorta splits into the left and right iliac arteries.
- The CT scan also showed a left internal iliac aneurysm, a localized dilation or bulging in the wall of the foal’s left internal iliac artery.
- Given the severity of the lesions discovered and the negative prognosis, the decision was made to euthanize the foal. A post-mortem examination corroborated the clinical findings.
Implications and Key Clinical Message
- The report emphasizes the significance of accurate diagnosis through CT to prevent unfruitful treatment approaches when dealing with unusual secondary complications, such as omphaloarteritis, an inflammation of the umbilical arteries.
- While umbilical complications are typically diagnosed in equine neonatal medicine and commonly result in septicemia (blood poisoning), physitis (inflammation of the growth plate), and septic arthritis, severe internal umbilical abscessation, and subsequent vascular and urinary disorders are less common.
Cite This Article
APA
Zakia L, Shaw S, Bonomelli N, O'Sullivan S, Zur Linden A, Dubois M, Baird J, Guest B.
(2021).
Hematuria in a 3-month-old filly with an internal umbilical abscess and internal iliac artery aneurysm.
Can Vet J, 62(8), 877-881.
Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
MeSH Terms
- Abscess / diagnosis
- Abscess / veterinary
- Animals
- Euthanasia, Animal
- Female
- Hematuria / etiology
- Hematuria / veterinary
- Horse Diseases / diagnosis
- Horses
- Iliac Aneurysm / diagnostic imaging
- Iliac Aneurysm / veterinary
- Iliac Artery / diagnostic imaging
References
This article includes 20 references
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Citations
This article has been cited 2 times.- Kozłowska N, Wierzbicka M, Jasiński T, Domino M. Advances in the Diagnosis of Equine Respiratory Diseases: A Review of Novel Imaging and Functional Techniques. Animals (Basel) 2022 Feb 4;12(3).
- Blirup-Plum SA, Jensen HE, Nielsen SS, Hartmann KT, Hansen MS, Pedersen KS, Larsen I, Nielsen JP, Olsen JE, Kudirkiene E, Barington K. Histopathological characterisation of omphalitis in piglets. Acta Vet Scand 2025 Aug 28;67(1):42.
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