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Risk factors and long-term prognosis of catheter-associated thrombophlebitis in neonatal foals.
Abstract: Thrombophlebitis is a possible complication of the use of indwelling catheters in hospitalized neonatal foals. Limited data are available concerning associated risk factors, and long-term prognosis regarding vein patency is currently unknown. Objective: Identify risk factors for catheter-associated thrombophlebitis in neonatal foals and assess long-term prognosis in a small subset. Methods: Two hundred twenty-three foals < 31 days of age, hospitalized in Utrecht University Equine Hospital between 2019 and 2024. Methods: Retrospective review of medical records. Foals that received an indwelling intravenous catheter and lived for at least two subsequent days were included. Odds ratios were determined, using logistic regression, for factors potentially associated with thrombophlebitis. Owners of affected horses were contacted, and horses available for follow-up were visited for clinical evaluation. Results: Twenty-one foals (9.4%) developed catheter-associated thrombophlebitis. In a multivariable model, hospitalization in the neonatal intensive care unit (NICU, OR 5.2, 95%CI 1.5-19.7), diarrhea (OR 4.6, 95%CI 1.4-17.3), Friesian breed (OR 4.1, 95%CI 1.1-13.9) and dwell time over four days (OR 3.9, 95%CI 1.3-14.8) were significantly associated with thrombophlebitis development. Seventeen affected foals survived to discharge. Eight horses, aged five months to five years, were available for follow-up by clinical evaluation and demonstrated appropriate blood flow. Conclusions: Risk factors for developing catheter-associated thrombophlebitis in hospitalized neonatal foals were identified. This knowledge can aid in implementation of preventive measures. Neonatal foals that are admitted to an equine hospital often need treatment with infusions, antimicrobials, and other medications. To allow this, a catheter is placed in a blood vessel in the neck. A possible complication of catheterization is thrombophlebitis. Thrombophlebitis is an inflammation of the vessel wall, with clot formation in the vein. In this study, medical records of 223 foals that received a catheter were studied. Twenty-one foals developed thrombophlebitis. Four risk factors were identified: hospitalization in an intensive care unit, diarrhea, being of Friesian breed, and the time the catheter was in the vein (dwell time). Additionally, owners of horses that were diagnosed with thrombophlebitis as neonate were contacted, and a small group of eight foals were re-examined five months to five years after their hospital stay. The veins of these eight foals appeared to be fully recovered. A better understanding of the risk factors of this complication enhances veterinarians’ knowledge of the condition and contributes to prevention.
© The Author(s) 2026. Published by Oxford University Press on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2026-10-25 PubMed ID: 42925543PubMed Central: PMC13695448DOI: 10.1093/jvimsj/aalag259Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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Risk factors for catheter-associated thrombophlebitis in hospitalized neonatal foals include intensive care hospitalization, diarrhea, Friesian breed, and catheter dwell time over four days. Long-term follow-up of affected foals suggests that vein function recovers well after the condition.
Background and Importance
- Neonatal foals in equine hospitals often require intravenous catheters to administer fluids, antibiotics, and medications.
- A known complication of catheter use is thrombophlebitis, characterized by inflammation of the vein wall and clot formation.
- Understanding risk factors helps veterinarians prevent thrombophlebitis and manage catheter use more effectively.
- Limited previous data were available on the specific risk factors and long-term outcomes of thrombophlebitis in neonatal foals.
Study Objectives
- Identify risk factors associated with catheter-associated thrombophlebitis in neonatal foals.
- Assess the long-term prognosis of affected foals, especially regarding vein patency and recovery after the event.
Methods
- A retrospective review of medical records from Utrecht University Equine Hospital between 2019 and 2024.
- Inclusion criteria: foals younger than 31 days old hospitalized and receiving an indwelling intravenous catheter, surviving for at least two days after catheter placement.
- 223 foals met the inclusion criteria.
- Statistical analysis using logistic regression to calculate odds ratios (OR) for potential risk factors.
- Owners of affected foals were contacted to evaluate long-term outcomes; a subset was clinically re-examined.
Key Findings – Risk Factors
- 21 out of 223 foals (9.4%) developed catheter-associated thrombophlebitis.
- Four significant risk factors identified in multivariable modeling:
- Hospitalization in the neonatal intensive care unit (NICU) – OR 5.2 (meaning foals in NICU were over 5 times more likely to develop thrombophlebitis).
- Presence of diarrhea – OR 4.6
- Being a Friesian breed – OR 4.1
- Catheter dwell time exceeding four days – OR 3.9
- These factors highlight risk linked to severity of illness (NICU admission & diarrhea), genetic predisposition (breed), and catheter management (duration).
Long-Term Prognosis
- Seventeen foals with thrombophlebitis survived to discharge from hospital.
- Eight foals (ranging in age from five months to five years) were available for follow-up clinical examination.
- All evaluated foals showed appropriate blood flow in the previously affected veins, suggesting full recovery of vein function.
- This indicates that although thrombophlebitis is a serious complication, long-term vein patency may not be significantly compromised in survivors.
Conclusions and Implications
- The study provides valuable evidence of specific risk factors that can be targeted for thrombophlebitis prevention in hospitalized neonatal foals.
- Preventive strategies might include minimizing catheter dwell time and careful monitoring of foals with diarrhea, NICU admission, or Friesian breed heritage.
- Long-term vessel recovery appears promising, alleviating concerns about permanent vein damage following thrombophlebitis in foals.
- Veterinarians can leverage this information to improve catheter protocols and client education for better outcomes.
Cite This Article
APA
van den Brom-Spierenburg AJ, Boer FAC, Theelen MJP, Siegers EW, van Oldruitenborgh-Oosterbaan MMS, Westermann CM.
(2026).
Risk factors and long-term prognosis of catheter-associated thrombophlebitis in neonatal foals.
J Vet Intern Med, 40(5), aalag259.
https://doi.org/10.1093/jvimsj/aalag259 Publication
Researcher Affiliations
- Division Equine Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
- Division Equine Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
- Division Equine Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
- Division Equine Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
- Division Equine Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
- Division Equine Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
MeSH Terms
- Animals
- Horses
- Horse Diseases / etiology
- Risk Factors
- Thrombophlebitis / veterinary
- Thrombophlebitis / etiology
- Animals, Newborn
- Retrospective Studies
- Male
- Female
- Prognosis
- Catheters, Indwelling / adverse effects
- Catheters, Indwelling / veterinary
Conflict of Interest Statement
Authors declare no conflicts of interest.
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