Uroperitoneum in 32 Foals: Influence of Intravenous Fluid Therapy, Infection, and Sepsis

Abstract

Foals may present to a referral hospital with the primary diagnosis of uroperitoneum (UP), or they may develop UP while hospitalized for other reasons. Historical, physical, laboratory, and diagnostic variables of foals presenting with UP were compared to those developing UP while hospitalized. Emphasis was placed on the presence of electrolyte abnormalities, evidence of sepsis or infection, and development of anesthetic complications during surgical correction of the defect. Foals developing UP while in the hospital frequently had a history of dystocia and presented at a very young age (< 48 hours) with primary clinical signs compatible with intrauterine compromise or presumed hypoxic or ischemic insult with or without sepsis. Foals referred with suspected UP often had additional problems unrelated to the urinary system. These foals had hyponatremia and hyperkalemia on presentation, whereas foals receiving intravenous fluid therapy consisting of a balanced electrolyte solution did not develop the classical pattern of electrolyte abnormalities, yet a similar increase in serum creatinine and, frequently, decreasing urine production were noted. Infection was present in 63% of the foals, and 78% of foals revealed signs suggestive of sepsis or infection. Intrauterine compromise, presumed hypoxia or ischemia, and sepsis may predispose foals to development of UP. Anesthetic complications occurred in 16% of the foals undergoing surgical correction of the defect, although hyperkalemia was only present in half of the foals with anesthetic complications.

Uroperitoneum secondary to rupture of the urachus associated with Clostridium spp. infection in a foal: a case report

“…Concomitant uroperitoneum and septicemia is a well described condition, but few investigations have shown that septicemia can be the direct causative effect of uroperitoneum in equine neonates, although it appears to be an important predisposing factor for the development of uroabdomen (Dunkel et al, 2005). In septic foals, E. coli and Actinobacillus equuli are the most commons organisms isolated from culture of the blood; while E. coli and Enterococcus spp.…”

Supportive care for the critically ill neonatal foal

“…An association between the development of uroperitoneum and hypoxic insults, infection and sepsis has been suggested (Dunkel et al 2005). The classic electrolyte abnormalities associated with the condition, namely hyponatraemia, hypochloraemia and hyperkalaemia may not be observed in foals receiving intravenous fluid therapy and the disease may only manifest as increased serum creatinine concentration and sudden decrease in urine production (Dunkel et al 2005, Kablack et al 2000. Diagnosis is best established by ultrasonographic examination of the abdomen.…”

“…Nevertheless, attempts are occasionally been made to selectively improve renal perfusion. Post renal failure must be ruled out in any critically ill neonate with decraeser urine output, as it may develop during hospitalization, as discussed below (Dunkel et al 2005, Kablack et al 2000.…”

Bladder rupture in the mature horse: Diagnostic techniques

“…2002). In neonates the condition is more common in colts (Hackett 1984), and may be associated with dystocia (Dunkel et al . 2005).…”