Neonatal Umbilical and Urinary Disorders

Question 1

Omphalitis

Answer 1

inflammation of external or internal umbilicus

Question 2

Omphaloarteritis

Answer 2

inflammation of umbilical arteries

Question 3

Omphalophlebitis

Answer 3

inflammation of the umbilical vein

Question 4

Omphalitis is most common in:

Answer 4

neonates <14 days

Question 5

Causes of omphalitis

Answer 5

• infection (most common)
• inflammation
• improper cord seperation

Question 6

Omphalitis clinical signs

Answer 6

1. frequent attempts to urinate
2. straining to urinate
3. urine dribbling from umbilicus
4. swollen, painful umbilicus
5. purulent material from umbilicus
6. fever

Question 7

Omphalitis Diagnosis

Answer 7

• clinical signs
• exam
• CBC: leukocytosis, leukopenia, hyperfibrinogenemia
• ultrasound

Question 8

Omphalitis Complications

Answer 8

• Septicemia
• Septic joints
• Osteomyelitis
• Peritonitis
• Pneumonia
• Meningitis

Question 9

Omphalitis treatment

Answer 9

1. medical – antibiotics if mild, normal temperature, normal CBC
2. surgery – abnormalities on ultrasound and CBC, external abscess, complications

Question 10

Omphalitis prognosis

Answer 10

prognosis is well unless infection can’t be resected, if the umbilical vein is infection, or systemic disease is present

Question 11

Umbilical Hernias are usually ___

Answer 11

Congenital

Question 12

Umbilical Hernia Treatment

Answer 12

1. conservative management – if easily reducible, may resolve spontaneously
2. surgery – if non-reducible (strangulation of intestines is an emergency) and failed to resolve conservatively

Question 13

Most common malformation of equine urinary tract

Answer 13

patent urachus

Question 14

Congenital patent urachus

Answer 14

failure to close due to excessive traction, too much abdmonial pressure, or twisting of umblicus

Question 15

Acquired patent urachus

Answer 15

• closes normally than reopens
• inflammation
• infection
• too much abdominal pressure (constipation or being lifted)

Question 16

Diagnosing patent urachus

Answer 16

1. PE – easy to ID during urination or moist umbilicus
2. CBC/Chem
3. Ultrasound +/- abdominocentesis

Question 17

Treating patent urachus

Answer 17

1. medical – urinary cathter, chlorhexidine dip, cautery (should close in a few days)
2. umbilical resection – if it does not close in > 3 days or in cases with concurrent omphalitis

Question 18

Uroperitoneum most commonly occurs in…

Answer 18

colts

Question 19

Etiologies of uroperitoneum

Answer 19

1. ruptured bladder due to increased pressure or congenital malformation
2. rupture of urachus

Question 20

Uroperitoneum clinical signs

Answer 20

1. born normal, will crash within 48-72 hours
2. lethargic and anorexic
3. abdominal distention
4. stranguria
5. colic

Question 21

Diagnosing uroperitoneum

Answer 21

1. ultrasound – large amounts of free fluid
2. chemistry – hyponatremia, hypochloremia, azotemia, hyperkalemia
3. fluid analysis – creatinine of abdominal fluid >2x serum values

Question 22

Why is hyperkalemia a problem?

Answer 22

slows heart rate by inhibiting myocardial depolarization

will also cause muscle tremors and neuro deficits

Question 23

Uroabdomen treatment

Answer 23

1. correct hyperkalemia
2. peritoneal drainage (slowly to correct hypoxia)
3. calcium to rasie membrane potential
4. surgery – not until foal is stable