Percutaneous retrieval of a jugular catheter fragment from the pulmonary artery of a foal.

The research article presents a case of a young Arabian foal with intestinal discomfort. A catheter accidentally cut off during attempted removal by the owner migrated from the jugular vein to the pulmonary artery. The article documents the challenging but successful retrieval of the catheter fragment using a percutaneous approach, marking the first such reported success in a horse.

Introduction and Background

• The foal, only 3 days old, was initially treated at a veterinary facility for diarrhea, loss of appetite, and signs of abdominal discomfort.
• In order to treat the foal, a catheter was inserted into the right jugular vein for medication and fluid administration.
• Catheter fragmentation is an established risk associated with catheterization, especially in horses. A fragment can migrate to critical organs such as the heart or pulmonary artery, making imaging and retrieval a challenge.

Case Development

• Upon discharge, the foal’s owner was instructed to continue treatment but accidentally severed the catheter at its base while attempting to remove it, leading to the catheter’s distal migration via the jugular vein.
• The fragment found its way into the pulmonary artery which warranted readmission of the foal to the hospital. This presented a higher risk as complications could include septicemia, endocarditis, lung abscesses, pulmonary embolism, dysrhythmias, cardiac perforation, pulmonary or caval thrombosis, and possibly death.

Treatment and Conclusion

• To extract the catheter fragment, veterinary professionals performed a percutaneous retrieval — a method that involves inserting instruments through the skin.
• This adversarial case represents the first documented successful retrieval of a catheter fragment from the pulmonary artery of a horse. The case study serves as a vital reference for potential future incidents of similar nature.