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The objective of this randomized clinical trial was to evaluate the effectiveness of a single application of 7% iodine tincture-based umbilical dip for preventing infection of the external umbilical structures in dairy calves. Five dairy farms in southern Ontario were visited twice weekly from September 2020 through June 2021. Female (n = 244) and male (n = 40) Holstein calves were randomly assigned at birth to receive either a 7% iodine tincture-based umbilical dip (n = 140) or no treatment (n = 144). Calves in the 7% iodine tincture umbilical dip group had the product administered once by the producer shortly after birth. For each newborn calf, the experimental group, calving difficulty, volume and timing of colostrum administration, time of birth, calving pen cleanliness, and the dam ID were recorded. Calf body weight was recorded during the first visit after birth, and a blood sample was collected for measurement of serum IgG concentration. Calves were health scored twice weekly from enrollment until approximately 30 d of age for assessment of external umbilical infection, joint inflammation, respiratory disease, and diarrhea. The primary outcome of the study was external umbilical infection, which was defined as an enlarged umbilicus with pain, heat, or a malodorous discharge. Calves were also weighed at 30 and 60 d to determine average daily gain. Serum IgG concentration and birth weight did not differ significantly between groups. Twenty-nine calves (20%) in the umbilical dip group developed an external umbilical infections, compared with 31 calves (22%) in the control group. A mixed logistic regression model, accounting for farm as a random effect, showed no effect of treatment on the incidence of an external umbilical infection. However, for every additional hour that calves received colostrum after birth, the odds of developing an external umbilical infection increased during the first month of life (odds ratio = 1.15; 95% confidence interval: 1.04–1.26). Additionally, treatment had no effect on respiratory disease, joint inflammation, diarrhea, average daily gain, or mortality, compared with the untreated control. These findings suggest that administering a single application of 7% iodine tincture dip to the umbilicus around the time of birth may not be effective for preventing external umbilical infections. Farm-level management factors, including colostrum management, appear to have more influence on risk of this disease. [ABSTRACT FROM AUTHOR]

Omphalitis is the third most common cause for diseases and infections in newborn calves. Its risk factors are well described in dairy production, but data in beef production is limited. To identify and quantify the risk factors of omphalitis in cow-calf operations with seasonal indoor calving period. Nine hundred sixty-four calves included from 22 cow–calf operations in central France were included. A prospective cohort study involved data collection during two visits for each calf. Simple and multivariable logistic regression analyses evaluated the association between omphalitis and the variables. Among 964 included calves, 311 (32.3%) calves had an omphalitis. Accounting for farms' random effect, risk factors for omphalitis highlighted by the univariable analysis were: absence of navel disinfection (odds ratio (OR) = 2.3, [1.45–3.04]), wetness of bedding calving area (OR = 1.8–2.1, [0.78–2.83]-[0.63–3.57]), cleanliness of calves' pen (OR =1.6–2.8, [1.22–2.27]-[2.02–3.84]), wetness of calves' pen bedding (OR = 1.7–3.2, [1.12–2.06]-[3.08–3.84]), calf weight at birth >50 kg (OR = 2.0–5.0, [1.02–2.38]-[1.51–11.1]), umbilical cord length <3 cm (OR = 2.2–2.3, [1.53–3.11]-[1.24–4.38]), and sex (male vs female) (OR = 2.6, [2.08–3.69]). The multivariable analysis, accounting for farms' random effect, showed that the absence of navel disinfection (OR= 2.2, [1.44–3.09]), wetness of bedding calving area (OR = 1.9–2.4, [0.55–2.83]-[0.59–3.28]), calf weight at birth >50 kg (OR = 1.9–2.6, [1.03–2.56]-[1.43–12.5]) and sex (male vs female) (OR =2.4, [2.09–3.49]) were risk factors for omphalitis. These observations may help identify animals at early risk (>50 kg, male, short umbilical cord) and pay particular attention to the wetness of bedding and cleanliness of housing. This study highlights the importance of calving-pen bedding, calf characteristics and navel disinfection. [ABSTRACT FROM AUTHOR]

The objective of this cross-sectional study was to determine the prevalence of disorders in preweaned calves in 3 regions in Germany, exemplary for structural diversity in dairy farming. A farm visit was performed on a single occasion on 731 dairy farms in the northern, eastern, and southern regions of Germany between December 2016 and July 2019. Farms differed in herd size, geographical location, and management. In the northern region, the farms had a median of 90 milking cows and were often run as full-time family businesses, partly with external workers. The eastern region tended to have larger farms (a median of 251 milking cows), which were often large-scale agricultural enterprises with employees. In the southern region, the farms had a median of 39 milking cows and were often traditional family businesses, some of these being part-time businesses. Clinical examinations were performed on 14,164 preweaned dairy calves (median 12 calves per farm) by trained veterinarians. A complete data set was available for 13,656 calves. Almost half (42.0%) of the evaluated calves were classified as being affected by at least 1 of the common calf disorders. Omphalitis (O, 20.9%; n = 2,876) and diarrhea (D, 18.5%; n = 2,670) were the most frequently recorded diagnoses, whereas respiratory diseases (RD) were observed to a lesser extent (8.7%; n = 1,100). A striking feature was the fact that 7.1% (n = 987) of the calves were affected by more than 1 disorder at the same time (multimorbidity, M). The following combinations of disorders were frequently observed: O and D (n = 596), O and RD (n = 164), and D and RD (n = 140). Disorders such as O and D, as well as M, were predominantly observed in calves aged 2 wk. A gradual increase in the frequency of RD was observed with age. For all disorders except RD, male calves were more often affected than females. Omphalitis was predominantly diagnosed in the summer months, whereas RD, D, and M were more common in the fall. We detected several statistically significant differences in the prevalence of clinical signs and disorders in preweaned dairy calves between the 3 exemplary regions. The prevalence of RD was higher in the south (10.8%) than in the north (8.2%) and east (7.4%). In the north (33.2%), O was observed more frequently than in the other regions (east: 18.9%; south: 10.5%), whereas D was found less frequently in the north (13.8%) than in the east (21.6%) and south (20.0%). [ABSTRACT FROM AUTHOR]

Liver abscesses in neonates are rare. Omphalitis is a very rare cause. We report a case of a voluminous neonatal pyogenic liver abscess following omphalitis, successfully managed in our institution. A 21-day-old full-term female newborn was brought to our institution for progressive febrile swelling of the right hypochondrium. The parents reported umbilical suppuration. Clinical examination confirmed the presence of a mass extending from the epigastric region to the right hypochondrium in a febrile baby with no other abnormalities. Laboratory investigations revealed an elevated C-reactive protein level (64 mg/dl) and hyperleukocytosis (20,800/mm3) with neutrophil predominance and normochromic microcytic anemia (hemoglobin 8.2 g/dl). Her first abdominal ultrasound was interpreted as a cyst of the common bile duct. Triple antibiotic therapy with cephalosporin, ampicillin and gentamycin was started, but unsuccessful. Abdominal ultrasound was repeated, revealing a hepatic abscess in segment 8, with a volume of approximately 17 ml. Percutaneous echo-guided drainage was performed and antibiotic therapy was readjusted after identification of the germ (Staphylococcus aureus) with good outcome. The baby was discharged two weeks later. At one month follow-up, the baby was completely asymptomatic. As neonatal liver abscesses are unusual, they can lead to misdiagnosis. Omphalitis is a very rare cause. Treatment by percutaneous echo-guided drainage is simple and effective. • Liver abscesses are uncommon in newborns. • Omphalitis is a very rare cause. • Abdominal ultrasound is the gold standard for the diagnosis, but it can be challenging. • Percutaneous ultrasound-guided drainage in neonates, rigorous antibiotherapy can produce satisfactory results. [ABSTRACT FROM AUTHOR]

The objectives were to investigate the effect of 3 navel dips on (1) umbilical infection, (2) health events (pneumonia, diarrhea, and arthritis), and (3) average daily gain (ADG) in newborn dairy calves. A secondary aim was to compare the agreement of standardized ultrasonographic examination with clinical examination for the diagnosis of umbilical infection. In a randomized block design, newborn calves were assigned by birth order to 3 treatment groups: Navel Guard (NG; SCGSolutions Inc., McDonough, GA), 7% iodine tincture (SI), and 2% chlorhexidine gluconate (CH). Treatment consisted of a single dip administration of the umbilicus immediately after removal of the newborn from the calving pen with 1 of the 3 navel dips. Weekly clinical examinations were carried out during the first 4 wk of life with special attention being paid to the umbilicus, joints, respiratory tract, and fecal consistency, and included ultrasonographic evaluation of the umbilical structures. Body weight was assessed by using a girth tape at first and last evaluation. Multivariable logistic regression demonstrated no statistical differences in umbilical infection or health events. Multivariable linear regression analysis showed statistical differences in ADG (least squares means ± standard errors) between groups, with 494 ± 29, 571 ± 29, and 516 ± 29 g/d in groups NG, SI, and CH, respectively. Overall mortality during the study period was 9.5% (n = 40). Postmortem examination identified diarrhea (80%) as the main disorder with 19, 4, and 9 calves in groups NG, SI, and CH, respectively. Kappa values yielded fair [0.30 (95% CI: -0.03-0.63)], good [0.61 (95% CI 0.46-0.75)], moderate [0.53 (95% CI 0.31-0.74)], and moderate [0.49 (95% CI 0.19-0.79)] agreement for detection of omphalitis between clinical and ultrasonographic evaluation in wk 1, 2, 3, and 4, respectively. Agreement was very good for detection of omphaloplebitis, with kappa values (95% CI) of 0.91 (0.80-1.00), 0.87 (0.75-0.98), and 0.90 (0.76-1.00) in wk 2, 3, and 4, respectively, when omphalophlebitis was diagnosed. We detected no difference in the effectiveness of the 3 treatments in the prevention of umbilical infection, pneumonia, diarrhea, or arthritis. [ABSTRACT FROM AUTHOR]

Objective: To examine the efficacy of topical chlorhexidine as an intervention on neonatal umbilical cord stumps and its association with neonatal mortality and omphalitis. Study design: Meta-analysis of randomized controlled trials (RCTs). Method: PubMed, EMBASE, CINAHL, IMSEAR, Google Scholar, Cochrane Central Register of Controlled Trials, Cochrane Pregnancy and Childbirth Group's Trials Register and Clinicaltrials. gov were screened until September 1, 2015 to identify RCTs that met the inclusion criteria. Pooled relative risks (RR) with 95% confidence intervals (CI) were calculated. Results: Five RCTs, conducted in Italy, Bangladesh, Nepal, Pakistan and India with a total of 55,008 participants were identified. Analysis revealed a significant reduction in the incidence of neonatal mortality among the intervention group as compared to the control group (pooled RR = 0.8; 95% CI: 0.6-1.0; P = 0.04; random effects model, I² = 58%; χ² = 9.5; P = 0.05). Additionally, decreased incidence in omphalitis was seen in the intervention group as compared to the control group (pooled RR = 0.4; 95% CI: 0.3-0.7; P < 0.001; random effects model, I² = 50%; χ² = 8.0; P = 0.09). Conclusions: Application of chlorhexidine to newborn umbilical cord stumps, significantly reduce the incidences of both neonatal mortality and omphalitis. However, high-quality trials from different regions and obstetric settings may help form more conclusive judgement on universal application of topical chlorhexidine. [ABSTRACT FROM AUTHOR]

Omphalitis is an infrequent neonatal infection of the umbilicus. Necrotizing infections are a rare complication of omphalitis that requires prompt antibiotic therapy, surgical debridement, and supportive care. Here, we present a rare case of Clostridium sordellii necrotizing omphalitis that progressed to severe toxemia characterized by refractory hypotension, massive capillary leak, leukemoid reaction, and absence of fever. These clinical features are common in C. sordellii infections and harbor a poor prognosis with only one reported survivor (out of 12) of C. sordellii omphalitis reported in the literature. Early antibiotic and surgical intervention remain the mainstay of care as no early detection assays or antitoxins are commercially available. [ABSTRACT FROM AUTHOR]

The objective was to verify if thermography is able to detect inflammatory signs on the skin surface by comparing the umbilical region of healthy calves and calves presenting omphalitis. Twenty healthy calves (control group) had their lateral umbilical region and abdominal region examined with a thermal imaging camera in order to obtain a regional thermograph. The thermographic examination was then performed on 27 calves (Omphalitis group) presenting omphalitis diagnosed by physical examination. The maximum temperature of the lateral umbilical region in calves (aged < 30 days) was 35.7 °C ± 1.8 for the control group and 37.0 °C ± 1.1 for the omphalitis group and was significantly different (p = 0.002). No difference was found on the temperature of the abdominal umbilical region. In the abdominal and lateral region the highest temperature site was differently positioned between the groups. In conclusion, thermography is able to detect inflammatory signs on the skin of newborn calves and has advantages as a non-invasive, fast and safe method of supporting veterinary diagnosis. [ABSTRACT FROM AUTHOR]

Résumé L’embryologie permet de comprendre les anomalies du cordon qui touchent les vaisseaux sanguins, le canal omphalo-mésentérique et l’ouraque. Les mécanismes en jeu dans la chute du cordon et de la cicatrisation des plaies permettent de comprendre la pathologie de l’ombilic. La hernie du cordon est une forme mineure d’omphalocèle. Un écoulement peut être dû à une inflammation, une infection ou à une fistule digestive ou ouraquienne. Ces 2 types de reliquats peuvent avoir un aspect pseudo-tumoral. Omphalites et morbidité infectieuse du premier mois dépendent de la qualité de l’hygiène de l’ombilic qui reste difficile à appréhender et doit s’adapter à l’environnement parental. Le traitement du granulome n’a pas fait ses preuves. Au-delà de 45 jours, la persistance du cordon fait rechercher une neutropénie ou un déficit de la phagocytose. Summary The embryologic development explains the umbilical abnormalities as number of artery and aspect, omphalomesenteric or allantoic ducts remnants. Mechanisms of umbilical cord separation and skin healing explain the umbilical secondary problems. Umbilical hernia is a minor coelosomia. Mild secretions can be due to inflammation, infection, omphalomesenteric allantoic ducts remnants. These remnants can look like tumors. Omphalitis and neonatal sepsis depend on topical cord care that remains unclear (antiseptic or not) but must be based on family knowledge and environment. The treatment of granuloma is unclear. Looking for neutropenia or phagocytosis abnormality is necessary if umbilical cord separation happens after 45 days of life. [ABSTRACT FROM AUTHOR]

Prenatally, the umbilicus is of paramount importance, providing the gateway between the mother and the fetus. As the fetus becomes increasingly autonomous at the end of the second month of fetal life, the connections (vitelline, urachal) diminish in significance and involute. Disturbances in this process can result in a wide variety of abnormalities, ranging from relatively minor defects identified at birth (umbilical granulation tissue) to life-threatening complications quiescent until late adulthood (urachal carcinoma). This section will review the ‘state of the art’ in evaluation and management of these umbilical and related abnormalities. [Copyright &y& Elsevier]

Abstract: Many of the problems associated with the umbilicus are congenital structural disorders. This contribution discusses embryology, disorders of the umbilicus (granulomas and polyps, omphalitis, dysmorphology, omphalomesenteric duct remnants, urachal remnants, hernias, exomphalos) and gatroschisis. [Copyright &y& Elsevier]

• Umbilical outpouchings are mainly due to umbilical herniation and/or formation of abscesses or fibrosis. • Early risk factors such as female gender, signs of immaturity and the condition of the umbilicus early in life are associated with the development of an umbilical outpouching. • Spontaneous regression of umbilical outpouchings occur in pigs. The main objective of the study was to identify early risk factors associated with the development of umbilical outpouchings (UOs) in pigs. Secondly, to describe 1) the nature of UOs, 2) the age when UOs become visible, and 3) at which age UOs spontaneously may regress and disappear. A longitudinal study following pigs (n=3031) from birth to slaughter was carried out in two commercial Danish herds. In total, 8 % (n=255) of the pigs developed an UO between birth and death (spontaneous, euthanasia or slaughter). The odds for developing an UO was significantly lower for males than females (OR, 0.7; 95% CL, 0.5-0.9). Pigs born immature (OR, 3.4; 95% CL, 1.3-8.2) or observed with: 1) clinical sign of omphalitis (OR, 1.8; 95% CL, 1.1-2.8), 2) a elongated moist umbilical cord at birth (OR, 5.1; 95% CL, 2.6-9.8) or 3) a healed or healing protruding umbilicus in the second week after birth (OR, 1.9; 95% CL, 1.4-2.6) were associated with significant higher odds of developing an UO. No significant association (p-value >0.05) was found between the development of UOs and sow parity, litter size, birth weight and length of the umbilical cord. The nature of the UOs were mainly due to umbilical herniation and/or formation of abscesses or fibrosis. The majority of UOs became visible within the first 10 weeks of age (80%, n=234). Spontaneous regression of the UOs occurred in 14% (n=36) of the pigs; 83% (n=30) disappeared between the 4th and 14th week. Identifying piglets with high odds of developing UOs makes it possible to identify to which pig special attention should be paid during the daily management. [ABSTRACT FROM AUTHOR]

Abscess formation of the falciform or round ligament of the liver is rare. A 15-year-old boy was diagnosed with Hirschsprung's disease after birth and underwent surgery for transverse colostomy at the site of the left upper abdomen in the neonatal period. A radical operation for Hirschsprung's disease was performed with a widely extended incision of the colostomy at 3 months of age. When he was 14 years old, he presented with lower abdominal pain due to a patent urachus. Six months after excision of the patent urachus, he returned to our outpatient clinic, showing pain and a palpable mass at the middle upper abdomen. We report herein a case of abscess formation of the round ligament of the liver after surgical resection of a patent urachus. We also review previous literature and discuss the possible pathogenesis and mechanisms of this phenomenon. [ABSTRACT FROM AUTHOR]