Management of uroperitoneum through combination of conservative and surgical treatments in two colts.
Abstract: Ruptures of the urinary bladder and urachus are the most frequent cause of uroperitoneum in foals. Surgical correction is often the first treatment choice, however, nonsurgical methods, such as urine removal via urinary catheters and abdominal drains, have been successfully performed in foals. Unassigned: Two foals were referred to the Equine Perinatology Unit for suspicion of uroperitoneum. The diagnosis was confirmed by hematobiochemical and ultrasound examinations, thus cystorrhaphy and cystoplasty were attempted. Surgeons found a lesion in the dorsocranial margin of the bladder (Case 1) and a tear in the pelvic urethra (Case 2); in the first case, the defect was routinely repaired, while the last lesion was impossible to repair due to its localization. A urinary catheter was left in place in both cases. Uroperitoneum recurred 72 hours after the surgery in both foals: a second surgical correction was not recommended due to the localization of the tears and conservative treatment, with the placement of a 32F chest tube in the most ventral part of the abdomen, was preferred. Abdominal drains were removed 5-7 days after surgery, while urinary catheters were left in place for up to 7-8 days. Colts' conditions improved during hospitalizations. Two months after bladder surgery, Case 1 was euthanized due to multiple adhesions between the small intestine and the abdominal wall. Case 2 was still alive one year postoperatively. Unassigned: Although it cannot be considered the first choice for the treatment of uroperitoneum in the foal, nonsurgical treatment was successful in both cases in the short-term follow-up. However, the prognosis should be cautious due to the risk of long-term complications. Conservative management may be used to manage bladder/urethral tears that cannot be solved by surgery.
Publication Date: 2023-11-30 PubMed ID: 38107226PubMed Central: PMC10725285DOI: 10.5455/OVJ.2023.v13.i11.11Google Scholar: Lookup
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Summary
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This research focused on the management of uroperitoneum in foals using a combination of surgical and non-surgical treatments, mostly emphasizing the role of conservative treatments when surgical options are not viable. It involved two case studies where nonsurgical treatment was applied successfully in the short term, but long-term complications were noted.
Summary of Study
Two colts suspected of having uroperitoneum were referred to the Equine Perinatology Unit. Diagnoses were confirmed through hematobiochemical and ultrasound examinations, which led to the decision to attempt surgical remedies including cystorrhaphy and cystoplasty. In both cases, reoccurrence of uroperitoneum was observed 72 hours post-surgery. Given the location of the tears, a second surgery was not recommended and conservative treatment was pursued.
- In Case 1, the location of the lesion was the dorsocranial margin of the bladder. Routine repair methods were applied to the defect. Despite initial successful surgical repair, uroperitoneum recurred and non-surgical treatment was applied. Unfortunately, the colt was euthanized two months postoperatively due to complications involving multiple adhesions between the small intestine and the abdominal wall.
- In Case 2, the tear was located at the pelvic urethra. This tear was impossible to correct surgically due to its location and hence, non-surgical treatment was employed from the onset. The colt was reported to be alive one year postoperatively.
Non-Surgical Treatment
Non-surgical treatment involved the insertion of a urinary catheter and abdominal drain in both colts. The abdominal drain was removed 5-7 days post-surgery, whereas the urinary catheters were maintained in place for 7-8 days. This helped manage the uroperitoneum by removing the accumulated urine.
Conclusion
While the first attempt was often surgical correction, these case studies showed the importance of having alternative treatment strategies in situations where surgery is not feasible due to the location of tears. Consequently, conservative management may be employed to manage such situations. However, despite nonsurgical treatment showing success in managing uroperitoneum in the short term, the researchers concluded with caution due to the potential for long-term complications. In these specific case studies, complications such as adhesions between the small intestine and the abdominal wall were observed. It is, therefore, crucial to consider these risks while opting for non-surgical management.
Cite This Article
APA
(2023).
Management of uroperitoneum through combination of conservative and surgical treatments in two colts.
Open Vet J, 13(11), 1471-1477.
https://doi.org/10.5455/OVJ.2023.v13.i11.11 Publication
Researcher Affiliations
MeSH Terms
- Animals
- Horses
- Male
- Peritoneal Diseases / diagnosis
- Peritoneal Diseases / etiology
- Peritoneal Diseases / surgery
- Peritoneal Diseases / veterinary
- Urinary Bladder / surgery
- Prognosis
- Horse Diseases / diagnosis
- Horse Diseases / surgery
Conflict of Interest Statement
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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