Surgical management and long-term outcome of umbilical infection in 65 foals (2010-2015).

Objective: To report the short- and long-term outcomes of surgical management of umbilical infection in foals.
Study Design: Retrospective case series.
Animals: Foals (n = 65).
Methods: Medical records (2010-2015) of foals up to 1 month of age, surgically treated for an umbilical infection were reviewed. Short-term (at the time of discharge from hospital) and long-term (1 year after surgery) survival rates were obtained. Clinical variables influencing survival were assessed. Chi-square or Fisher's exact test were used to evaluate the relationship between the data retrieved and outcome. P ≤ .05 was considered statistically significant.
Results: Sixty-five foals were included in the study, representing 17.2% of all foals admitted to the hospital. Fifty foals were discharged from hospital (77%) and 43 foals (66%) were alive 1 year after surgery. Lower long-term survival rates were associated with: younger age at presentation, septic joints, multiple pathologies, higher creatinine level, higher heart rate, umbilical infection diagnosed at the hospital rather than prior to referral, prolonged hospitalization, longer period between arrival and surgery, and postoperative complications. The most common surgical findings were urachal enlargement followed by right arterial enlargement.
Conclusion: Younger foals with worse systemic condition and concurrent disorders are at higher risk for treatment failure. Early diagnosis improves the outcome. Surgical treatment yields good results and should be considered upon diagnosis, after taking into account the clinical situation.
Clinical Significance: Based on the results of this study, diagnosis and surgical management of umbilical infection in neonatal foals should be performed as early as possible, and a good outcome can be expected after surgery.
(© 2017 The American College of Veterinary Surgeons.)