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.