Basics of Umbilical Disorders

Question 1

What are the umbilical structures and what do they turn into

Answer 1

umbilical vein - round ligament of liver
umbilical arteries - round lig of the bladder
urachus - connects the bladder and allantois

Question 2

whos at risk for acquired umbilical patent urachus?

Answer 2

debilitated foals

septicemic foals

Question 3

Patent urachus can cause

Answer 3

septic arthritis
spetic physitis
septicemia

Question 4

Clinical signs of a patent urachus

Answer 4

moisture around navel

drip or stream from umbilicus when posturing to urinate

Question 5

Dx of Patent urachus

Answer 5

Clinical signs
positive contrast rads
ultrasound* - vesicourachal patency, umbilical or urachal abscess.

Question 6

Tx of patent urachus

Answer 6

BS AM for up to 5 days. If nothing, surgerize

Question 7

Indications for surgery

Answer 7

failure to respond to AM

rent in urachus that produces SQ swelling

Question 8

Surgery procedure

Answer 8

dorsal recumbency
elliptical incision
dissect umbilicus and urachus from body wall
ligate the umbilical vein and cut, 
ligate the umbilical arteries and cut (and part of the bladder too)
2-incision pattern to close bladder
lavage abdomen with saline
close up

Question 9

post-op care for patent urachus

Answer 9

AM 3-5 days
stall rest for 2 weeks
remove sutures at 14 days

Question 10

CLinical signs of Omphalophlebitis

Answer 10

overt signs of infection
high WBC and fibrinogen
joint infection, diarrhea, penumonia concurrently

Question 11

Dx of Omphalophlebitis

Answer 11

careful palpation

US

Question 12

how long can the vessels in urachal region be seen after birth?

Answer 12

umb vein - 2 months, but should be hypoechoic and

Question 13

Tx of Omphalophlebitis

Answer 13

BS AM (for up to 2-3 weeks) –> esp chloramphenicol, but the notes say PenGent
re-evaluate every 5-7 days
surgerize

Question 14

After care of Omphalophlebitis patients includes

Answer 14

monitoring for evidence of septicemia –> esp joints.

stall rest for 2 weeks

Question 15

prognosis of Omphalophlebitis

Answer 15

if into liver, poor

Question 16

Umbilical hernia reasons for forming

Answer 16

failure of umbilical stump to completely heal after birth
Attributed to:
- trauma during birth
-excessive straining
-umbilical cord infection

Question 17

3 portions of the Umbilical hernia

Answer 17

1. the ring
2. the hernia sac
3. the contents of an abdominal hernia

Question 18

Dx of Umbilical hernia

Answer 18

digital palpation - see ring size nature of contents,

DON’T LANCE UNTIL YOU KNOW

Question 19

An Umbilical hernia is reducable if…

Question 20

We go to surgery for Umbilical hernia when…

Answer 20

not spont heal in 4 months
greater than 10 cm in diameter
when there is incarceration
any increase in hernia size, firmness, edema, or pain on palpation

Question 21

Hernia clamps are good right?

Answer 21

NO.

Question 22

Surgery includes…

Answer 22

GA in dorsal recumbency
elliptical incision
expose rectal sheath of rectus abdom muscle
do the technique open or closed, 
then simple continuous to close suture
regular closing

Question 23

What is the open technique for Umbilical hernias?

Answer 23

the abdomen is entered. to get the guts in the right place that way.

Question 24

What is the closed technique for Umbilical hernias?

Answer 24

the abdomen is not entered and the hernia is just inverted and sewn up

Question 25

what are aftercare considerations compare to a castration?

Answer 25

stall confinemnet for a month to 1.5.

Castration is walk around so don’t do both at the same time.