Clinical, ultrasonographic, and surgical findings in foals with umbilical remnant infections

Infection of umbilical arteries, umbilical vein, and/or urachus was diagnosed ultrasonographically in 33 foals 1 to 90 days old (mean, 17.7 +/- 17.3 days). In these foals, the most common initial problems were umbilical abnormalities, septic arthritis, and/or neonatal septicemia. In 16 foals, abnormalities of the external umbilical stalk were noticed on admission. Abnormalities of the internal umbilical structures were identified when enlargement and echogenic material (fluid and/or gas) were imaged ultrasonographically within these structures. Multiple structures were affected in 23 foals, with the urachus the most commonly affected structure. Surgical findings confirmed ultrasonographic identification of infected umbilical structures in 23 foals. Twenty-two samples from affected umbilical remnants submitted for culture at surgery were positive for bacterial growth. Multiple organisms were isolated in 15 cultures. Escherichia coli and beta-hemolytic streptococci were the most common isolates. Two foals died of late complications associated with surgical resection, 1 foal treated surgically and 3 foals treated medically died or were euthanatized because of other complications, and the remaining 27 foals lived.     

Umbilical cord remnant infections in foals: 16 cases (1975-1985)

Infection of the umbilical cord remnants was diagnosed in 16 foals. The infection was found in the urachus alone in 3 foals, the umbilical arteries in 2 foals, the urachus and umbilical arteries in 3 foals, the urachus and umbilical vein in 2 foals, and the urachus, umbilical vein, and umbilical arteries in 2 foals. The specific location of the infection was not determined in 4 foals. Eleven foals developed an acquired patent urachus between 4 and 16 days of age. Seven foals had one or more joints infected. All foals with umbilical cord remnant infections were treated with orally, intramuscularly, or intravenously administered antibiotics and 9 foals had the umbilical cord remnants excised. Nine foals survived, 6 of which had had excision of the infected remnants. Only 2 foals with joint infections survived.     

Surgical management of umbilical masses with associated umbilical cord remnant infections in calves

Intra-abdominal umbilical cord remnant infections were diagnosed in 21 calves during a 5-year period. The urachal remnant alone was involved in 15 calves, umbilical artery remnant alone in 1 calf, and the umbilical vein remnant alone in 4 calves. Both urachus and umbilical vein were involved in 1 calf. All cases were managed surgically by ventral celiotomy. Infected urachal remnants not extending to the bladder, infected umbilical artery remnant, and infected umbilical vein remnants not extending to the liver were dissected free of surrounding adhered structures, ligated proximal to the infected segment, transected, and removed. Infected urachal remnants extending to the bladder were similarly isolated and removed after resection of the attached bladder apex. Infected umbilical vein remnants extending to the liver were marsupialized. Of 19 calves available for follow-up from 1 to 32 months after surgery, 15 recovered without any postoperative complications, 3 had short-term complications, and 1 calf developed an incisional hernia.     

Laparoscopic Abdominal Anatomy of Foals Positioned in Dorsal Recumbency

Eleven foals (nine cadavers and two anesthetized) positioned in dorsal recumbency were examined to describe normal abdominal anatomy viewed by laparoscopy. The foals ages ranged from 1 to 150 days. Insertion sites were selected for a Verres needle, laparoscope and instrument portals to avoid trauma to the umbilical structures. The abdominal cavity was insufflated to a pressure of 10 to 12 mm Hg using an automatic carbon dioxide insufflator. Laparoscopic examination allowed excellent observation of the umbilical structures, the bladder, the genital tract, the inguinal area, the liver and segments of the intestinal tract in all foals. However, the duodenum and ileum were not identified. An embryonic vestige of the yolk stalk (ductus pedunculi vitellini) was identified in six foals. In four foals, this appeared as a fibrous band extending from the umbilicus to the cranial abdominal cavity where it inserted on the small intestine. In two foals only the fibrous umbilical portion of the band was observed.     

Persistent urachal remnant causing intestinal strangulation in a cow

A persistent urachal remnant causing small intestinal strangulation was found on exploratory laparotomy in a 2-year-old cow with colic. The persistent urachus consisted of a thin cord-like band that was attached ventrally to the umbilical region and caudally to the apex of the bladder. The band had formed an internal loop and had strangulated 6 to 8 cm of the distal portion of the ileum. The persistent urachus was detached manually at the umbilicus, ligated at the apex of the bladder, and removed; intestinal resection was not necessary. The urachal remnant was probably a congenital abnormality that may have become stretched during pregnancy, forming an internal hernial loop.     

Infection of internal umbilical remnant in foals by Clostridium sordellii

Omphalitis and the resulting septicemia contribute to perinatal mortality in several animal species. In foals, the most important causes of omphalitis are Escherichia coli and Streptococcus zooepidemicus. However to date, no information has been published about the role of Clostridium sordellii in these infections. In this paper, we describe 8 cases of perinatal mortality in foals associated with internal umbilical remnant infection by C. sordellii. The foals studied were between 12 and 21 days old at the time of death, and various breeds were represented in the group. Five of the foals were male and 3 were female. The diagnosis was established on the basis of the detection of C. sordellii by 3 methods (culture, fluorescent antibody test, and immunohistochemistry) and on gross and histopathologic findings. All foals had acute peritonitis, and the internal umbilical remnant was thickened by edema, hemorrhage, and fibrosis. A moderate amount of serosanguinous fluid with fibrin strands was present in the pericardial sac and pleural cavity. Histopathologically, the urachus and umbilical arterial walls were thickened by edema and exhibited hemorrhage, fibrin, and leukocytic infiltration. Gram-positive bacterial rods were observed in subepithelial areas of the urachus, the adventicia of umbilical arteries, and interstitium of the internal umbilical remnant. On the basis of these findings, we suggest that C. sordellii should be considered in the differential diagnosis for infections of the internal umbilical remnant in foals.     

ULTRASONOGRAPHY OF THE LIVER, SPLEEN, AND URINARY TRACT OF THE CHEETAH (ACINONYX JUBATUS)

Diseases of the abdomen of the cheetah (Acinonyx jubatus) include those affecting the liver, spleen, and urinary tract. The most common diseases of captive-bred cheetah are gastritis, gastric ulceration, glomerulosclerosis, and hepatic veno-occlusive disease, and are the most frequent causes of mortality in these animals. The purpose of this study was to describe the ultrasonographic anatomy of the normal liver, spleen, kidney, and urinary bladder of the anesthetized captive-bred cheetah. Twenty-one cheetahs were examined. Eight of the 21 animals had subclinical evidence of either gastritis or chronic renal disease. The ultrasonographic appearances of the liver, gall bladder, common bile duct, and spleen were evaluated and various measurements made. Statistical analyses of the measurements were performed on all the healthy and subclinically ill animals taking sex, age, mass, and anesthetic protocol into account. There were no significant differences in any parameters between the healthy and subclinically ill animals (P > 0.25) and data were combined for statistical analyses. The mean mass was 41.1kg ( +/- 8.8) and the mean age was 5.0 years (+/- 2.2). The mean thickness of the liver medial to the gall bladder was 67.0 mm (+/- 14.8) and the liver was within the left costal arch in 75% of animals, extended caudal to the right costal arch in 50% of animals for an average of 30 mm, and extended caudal to the sternum in 63% of animals for an average of 32.5 mm. The maximum mean hepatic vein diameter at the entrance to the caudal vena cava was 8.6 +/- 2.8 mm; the mean diameters of the portal vein at the hilus and that of the caudal vena cava as it entered the liver were 7.5 +/- 1.6 and 9.9 +/- 4.1 mm, respectively. The mean diameter of the caudal vena cava was significantly affected by the type of anesthetic used (P < 0.10). The mass of the animals was significant in explaining the variance in maximum portal vein diameters (P < 0.10). The mean maximum velocity of the hepatic vein flow at the entrance to the caudal vena cava was 25.3 +/- 2.8 cm/s (n=4), the hilar portal vein was 11.7 +/- 3.3 cm/s (n=7), and the caudal vena cava was 33.8 +/- 19.8 cm/s (n=5). The mean maximum gall bladder length and width, and the mean common bile duct diameters were 44.6 mm (+/- 10.4), 23.3 mm (+/- 5.0), and 8.1 mm (+/- 2.4), respectively. Age was significant in explaining the variance in gall bladder lengths (P<0.10). Urinary tract ultrasonography was performed only in animals that had normal urea and creatinine levels (n=13). Renal cortico-medullary distinction was present in all kidneys and a cortico-medullary rim sign was seen in 21 of 26 kidneys. Mean kidney length, height, and width was 63.9 +/- 5.7, 38.1 +/- 5.2, and 42.1 +/- 5 mm, respectively. The average resistivity index was 0.58 (n=5). Mean urinary bladder length, height, and width were 57.0, 19.2, and 34.9 mm, respectively.     

Omphalocele in a foal

An omphalocele was detected at birth in a male Arabian foal. The mass contained small intestine and after releasing a constricting band at the body wall, the contents slipped easily back into the abdomen. On the outside was the hairless pink membrane. The interior, now empty of small intestine, contained the umbilical arteries and vein, and a large urachus that extended from the bladder to the opening at the extremity of the mass. Six days after corrective surgery the foal was sent home and remained healthy.     

THE RADIOGRAPHIC APPEARANCE OF THE PULMONARY VASCULATURE IN THE CAT

The purpose of this study was to determine the dimensions of the pulmonary arteries and veins in the cat, both in normal animals and those with evidence of intrathoracic disease. The radiographs of 50 normal cats, 35 cats with hypertrophic cardiomyopathy (HCM), and 15 cats with other intrathoracic disease were assessed. The normal range for the right cranial lobar artery compared with the proximal third of the fourth rib was 0.5-1.0, with a mean artery-to-rib ratio of 0.70 (standard deviation +/- 0.13). Normal cats had a mean vein diameter of (0.20 +/- 0.03 cm) (P = 0.034) compared with cats with HCM, which had a significantly greater mean vein diameter (0.22 +/- 0.04 cm).     

Laparoscopic Repair of Scrotal Hernia in Two Foals

Nonstrangulating indirect scrotal hernias were corrected in two 4-week-old Percheron foals by a laparoscopic technique. After laparoscopic reduction of herniated nonstrangulated small intestine each testes was retracted through the vaginal ring. The ligament of the tail of the epididymis was transected by electrocautery. The testicular vessels and nerves were isolated by cautery of the mesenteric portion of the mesorchium and then ligated. Staples were used to close the opening of the inguinal canal by apposing the peritoneal edges of the vaginal ring. Resection of umbilical stalk remnants via celiotomy performed in one foal after laparoscopic observation of enlargement of the right umbilical artery and urachus. No complications or recurrence of herniation had occurred 16 weeks after surgery.     

Cochet-Bonnet aesthesiometer-determined corneal sensitivity in neonatal foals and adult horses

Corneal touch threshold (CTT) was measured in sick neonatal foals, healthy foals, and healthy adult horses with a Cochet-Bonnet aesthesiometer. The mean overall CTT for the adult horses, sick foals, and healthy foals was 4.82 +/- 0.87 cm, 3.21 +/- 0.24 cm, and 5.01 +/- 0.61 cm, respectively. The central cornea of adult horses was more sensitive than the limbal cornea. Corneal sensitivity was significantly reduced in sick neonatal foals compared to adults. The mean Schirmer I tear test values were significantly lower in foals than adults, and were 14.2 +/- 1.0 mm, 12.8 +/- 2.4 mm, and 18.3 +/- 2.1 mm wetting in sick neonatal foals, normal neonatal foals, and adult horses, respectively. Reduced corneal sensation and lower tear production may be associated with ulcerative keratitis and slow corneal healing in some foals.     

Ultrasonographic appearance of the uterus, placenta, fetus, and fetal membranes throughout accurately timed pregnancy in beagles.

Serial ultrasonographic examinations were performed on 8 Beagle bitches from 20 to 60 days pregnant to determine time of first detection, appearance, and sizes of selected features of pregnancy. Gestation was timed from the day of the preovulatory luteinizing hormone surge. Findings related to gestational age were consistent among bitches. Gestational ages at earliest detection of the following features were: chorionic cavity at day 20; placental layers in the uterine wall at day 22 to 24; zonary placenta at day 27 to 30; embryo and heartbeat at day 23 to 25; yolk sac membrane at day 25 to 28; allantoic membrane at day 27 to 31; choroid plexus of the brain at day 31 to 35; fetal movement at day 34 to 36; skeleton at day 33 to 39; bladder and stomach at day 35 to 39; kidney at day 39 to 47; and liver hypoechoic, compared with lung, at day 38 to 42. Extra-fetal structures were measurable from day 20 or 22 through day 48. Chorionic cavity diameter increased from 0.2 +/- 0.0 cm to 3.3 +/- 0.2 cm, outer uterine diameter increased from 0.8 +/- 0.03 cm to 4.8 +/- 0.2 cm, length of chorionic cavity or zonary placenta increased from 0.3 +/- 0.03 cm to 4.9 +/- 0.05 cm, uterine wall thickness increased from 0.3 +/- 0.03 cm to 0.8 +/- 0.01 cm, and placental thickness increased from 0.1 +/- 0.0 cm to 0.5 +/- 0.05 cm. Chorionic cavity diameter, outer uterine diameter, and placental length each increased at a linear rate through day 37, after which time, each had a marked plateau in growth. Of the extra-fetal structures, chorionic cavity diameter was the most accurate for estimation of gestational age. All of the fetal structures studied increased at an increasing (second order) rate. Crown-rump length increased from 0.3 +/- 0.05 cm on day 24 to 9.2 +/- 0.2 cm on day 48. Body diameter increased from 0.2 +/- 0.03 cm on day 24 to 4.6 +/- 0.15 cm on day 60. Head diameter increased from 0.8 +/- 0.05 cm on day 34 to 2.7 +/- 0.04 cm on day 60. Of the fetal structures, head diameter was the most accurate for estimation of gestational age.     

A One-Stage Marsupialization Procedure for Management of Infected Umbilical Vein Remnants in Calves and Foals

Five Holstein calves and two foals with omphalophlebitis were treated by surgical marsupialization of the umbilical vein remnant because complete resection of the infected tract was not possible. The infected umbilical stalk was resected, and the umbilical vein remnant was marsupialized in a one-stage procedure by suturing it into the abdominal wall lateral to the abdominal incision. Antimicrobial drugs were administered, and the marsupialized tract was irrigated until closure by second intention healing. Cellulitis associated with the marsupialization site occurred in two calves but resolved with antimicrobial therapy. Owners reported that, 9 to 60 months after surgery, there were no complications associated with the procedure.     

Use of an Endoscopic Suturing Device for Laparoscopic Resection of the Apex of the Bladder and Umbilical Structures in Normal Neonatal Calves

OBJECTIVE: To develop a laparoscopic technique using an endoscopic suturing device for the resection of the apex of the bladder and the umbilical structures in large-animal neonates. Study Design-Experimental study. Animals or Sample Population-Seven healthy male Holstein calves. METHODS: A laparoscopic technique for resection of the apex of the bladder was developed on 2 calf cadavers, then evaluated on 5 anesthetized calves. The calves were positioned in dorsal recumbency, and 4 ventral abdominal portals were used. The umbilical vessels were double-ligated using an endoscopic suturing device and subsequently transected. The apex of the bladder was transected between a row of laparoscopic clips applied near the apex and atraumatic laparoscopic forceps applied distally; then, the edges were apposed using an endoscopic suturing device. The dissected umbilical remnants were removed from the abdomen through a small incision centered at the umbilicus. One month later, the calves were euthanatized and a second-look laparoscopy performed; then, bladders were collected for gross and histologic examination. RESULTS: No major complications occurred during or after surgery. The endoscopic suturing device permitted both effective ligation of the umbilical vessels and closure of the bladder. During second-look laparoscopy, healing of the peritoneal surface of the bladder and umbilical vessels was assessed to be excellent in 4 calves. A focal adhesion of omentum to the bladder suture line was observed in 1 calf. Focal adhesions of the omentum to the umbilical incision site occurred in 2 calves. The bladder mucosa was completely healed at the surgical sites. CONCLUSION AND CLINICAL RELEVANCE: Resection of the apex of the bladder and umbilical vessels in calves can be accomplished laparoscopically using an endoscopic suturing device.     

Duplex ultrasonography of the common carotid artery and external jugular vein of cows

OBJECTIVE: To determine blood flow patterns in the common carotid artery and external jugular vein in cows before and after sedation achieved by administration of xylazine hydrochloride. ANIMALS: 30 clinically normal Swiss Braunvieh cows. PROCEDURE: A 5.0-MHz sector transducer was used to examine the common carotid artery and external jugular vein before and after cows were sedated by administration of xylazine. Several variables were calculated, including diameter of the blood vessels, blood flow velocity, and flow-time volume. RESULTS: The common carotid artery before sedation had a maximum systolic velocity of 89 +/- 8.5 cm/s, maximum diastolic velocity of 36 +/- 6.0 cm/s, mean velocity of 35 +/- 5.4 cm/s, and flow-time volume of 28.2 +/- 3.48 cm3/s. In all cows, sedation achieved by administration of xylazine resulted in a significant decrease in velocity of arterial blood flow and flow-time volume. The external jugular vein before sedation had a maximum velocity of 65 +/- 8.3 cm/s, maximum velocity of retrograde venous blood flow of 20 +/- 6.6 cm/s, and flow-time volume of 29.7 +/- 5.42 cm3/s. These values decreased significantly after cows were sedated by administration of xylazine. CONCLUSIONS AND CLINICAL RELEVANCE: Doppler ultrasonography is particularly suitable for evaluation of blood flow patterns in the common carotid artery and external jugular vein of healthy cows. The results reported here provide a basis for use in examination of cows with cardiac and blood vessel disease.     

Changes in liver copper concentration of thoroughbred foals from birth to 160 days of age and the effect of prenatal copper supplementation of their dams

OBJECTIVES: To monitor the change in liver copper concentration of Thoroughbred foals from birth to 160 days of age and to determine the effects of supplementation by two injections of copper edetate given to dams in late gestation on the liver copper concentration of their foals at birth. PROCEDURE: Ten mares pregnant to the same stallion were randomised into two groups on the basis of age, liver copper concentration and expected foaling date. The treatment group mares were given 100 mg and 250 mg copper edetate intramuscularly during the ninth and tenth months of gestation respectively. Foals had liver biopsies taken weekly in the first month of life, then monthly for four months. Foals were euthanased at 160 days of age; liver samples were taken and the copper concentrations were determined. RESULTS: Two distinct patterns of age dependent decline in liver copper concentration were evident. The mean (+/- SD) liver copper concentration of the foals was high at birth (374 +/- 130 mg/kg DM), and for seven it declined to adult values by 160 days of age (21 +/- 6 mg/kg DM). In three foals the decline was at a slower rate than in the other seven and at 160 days of age the mean concentration was 162 +/- 32 mg/kg DM. Repeated measures analysis showed significant differences between each biopsy (P < 0.01) and between 'normal' and 'accumulator' foals (P < 0.002). Copper injections given to mares in late pregnancy had no effect on the liver copper concentration of foals at birth. CONCLUSIONS: The significance of the two patterns of age dependant decline in liver copper concentration is unknown. Parenteral copper supplementation of the dam in late gestation had no effect on the liver copper concentration of the foal at birth.     

The effect of omeprazole paste on intragastric pH in clinically ill neonatal foals

REASON FOR PERFORMING STUDY: Administration of omeprazole paste per os to healthy neonatal foals has been shown to effectively increase intragastric pH, but has not been evaluated in sick neonatal foals. OBJECTIVES: To determine the effect of orally administered omeprazole paste on intragastric pH in clinically ill neonatal foals requiring nasogastric intubation. METHODS: Intragastric pH was measured continuously for 24 h using an indwelling electrode and continuous data recording system in hospitalised neonatal foals age < or =2 days. Intragastric pH was measured for 12 h prior to (pretreatment period) and 12 h following (post treatment period) treatment with omeprazole paste (4 mg/kg bwt per os). All foals displayed periods of acidity (pH <4) prior to treatment. Statistical analysis compared pre- and post treatment mean and median intragastric pH, and percentage of time below pH 4. RESULTS: Eight foals were evaluated age 1-3 days, a gestational age of at least 320 days or reported to be full term. The mean (3.19 +/- 1.50 vs. 6.20 +/- 0.93) and median (4.6 +/- 1.7 vs. 6.86 +/- 0.89) pH were significantly higher and the percentage of time below pH 4 (32.25 vs. 1.1%) was significantly lower in the post treatment compared to the pretreatment period. CONCLUSION: Omeprazole paste effectively increases intragastric pH in clinically ill neonatal foals after one dose at 4 mg/kg bwt orally.     

Ultrasonography of the spleen in 50 healthy cows

This paper describes the ultrasonographic appearance, location and size of the spleen in 50 healthy commercial milk cows destined for slaughter. The intercostal spaces of the left thoracic wall were scanned with a 3.5 MHz linear transducer. In each intercostal space, the appearance of the splenic parenchyma, the dorsal and ventral margins and the distance between them, and the diameter of the splenic vessels were recorded. The spleen was seen in intercostal spaces 7-12. It was 2.0-5.0 cm thick, and tapered ventrally. The splenic capsule appeared as an echogenic line. The splenic parenchyma consisted of numerous small regularly spaced echoes, and vessels within the parenchyma appeared as anechoic round to oval or elongated images. The long axis was oblique, running caudodorsal to cranioventral. The distance from the dorsal margin of the spleen to the midline of the back was greatest in the 7th intercostal space (60.9+/-6.81) and smallest in the 12th intercostal space (12.7+/-2.85 cm). The extent of the spleen was greatest in the 8th intercostal space (24.9+/-10.77 cm) and smallest in the 12th intercostal space (9.5+/-5.38 cm). The mean diameter of the splenic vessels ranged from 0.66+/-0.28 to 0.90+/-0.65 cm, depending on the intercostal space scanned. Ultrasonography of the spleen in healthy cows provides information that can be used as a reference when examining cattle with suspected splenic disease.     

Disposition of orally administered cefpodoxime proxetil in foals and adult horses and minimum inhibitory concentration of the drug against common bacterial pathogens of horses

OBJECTIVES: To determine the disposition of orally administered cefpodoxime proxetil in foals and adult horses and measure the minimum inhibitory concentrations (MICs) of the drug against common bacterial pathogens of horses. ANIMALS: 6 healthy adult horses and 6 healthy foals at 7 to 14 days of age and again at 3 to 4 months of age. PROCEDURE: A single dose of cefpodoxime proxetil oral suspension was administered (10 mg/kg) to each horse by use of a nasogastric tube. In 7- to 14-day-old foals, 5 additional doses were administered intragastrically at 12-hour intervals. The MIC of cefpodoxime for each of 173 bacterial isolates was determined by use of a commercially available test. RESULTS: In 7- to 14-day-old foals, mean +/- SD time to peak serum concentration (Tmax) was 1.7 +/- 0.7 hours, maximum serum concentration (Cmax) was 0.81 +/- 0.22 microg/mL, and elimination half-life (harmonic mean) was 7.2 hours. Disposition of cefpodoxime in 3- to 4-month-old foals was not significantly different from that of neonates. Adult horses had significantly higher Cmax and significantly lower Tmax, compared with values for foals. The MIC of cefpodoxime required to inhibit growth of 90% of isolates for Salmonella enterica, Escherichia coli, Pasteurella spp, Klebsiella spp, and beta-hemolytic streptococci was 0.38, 1.00, 0.16, 0.19, and 0.09 microg/mL, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Oral administration at a dosage of 10 mg/kg every 6 to 12 hours would appear appropriate for the treatment of equine neonates with bacterial infections.