Umbilical swelling in calves

Question 1

Where do the umbilical vessels travel?

Answer 1

Umbilical vein going cranially up towards the liver

Urachus and two umbilical arteries are going caudally to the bladder and aorta

Question 2

What do the following become?
Umbilical artery:
Umbilical vein:
Urachus:

Answer 2

Umbilical artery = Round ligament of the bladder
Umbilical vein = The round ligament in the falciform ligament
Urachus = Scar on bladder

Question 3

Which two questions should be asked when gathering the history of an animal with an umbilical swelling?

Answer 3

When seen, progression?

Urination observed?

Question 4

Describe the feature of the general clinical exam of a calf with an umbilical swelling

Answer 4

Check for spread / source of infection
Suck reflex
Joints – joint ill
Lungs 
CNS

Question 5

On palpation is the swelling is reducible into the abdomen it is …?

Answer 5

A simple hernia

Question 6

On palpation is the swelling is partially reducible into the abdomen it is …?

Answer 6

Hernia and abscess

Question 7

On palpation is the swelling is irreducible into the abdomen it is …?

Answer 7

Abscess
Hernia complicated by:
- Incarceration
- Strangulation
- Adhesions

Question 8

Resistance of palpation =?

Answer 8

Pain

Question 9

Pitting oedema = ?

Answer 9

urolithiasis & urethral rupture

Question 10

How can you identify discharging tracts?

Answer 10

Pass a blunt probe – bitch urinary catheter:

• Does it go cranially or caudally?
• How far does it go in?
• Through the body wall?
• Where is this anatomically?

Inject radio-opaque contrast medium and take radiographs - superseded by ultrasonography

Question 11

Describe B-mode ultrasonography for umbilical swellings detection and diagnosis

Answer 11

• Identify structure in mass e.g. abscess / pus, urachus, vessel, gut (+/- peristalsis)
• Detect areas of pus in urachus / vessels within abdomen and follow structures
• Detect peritonitis and adhesions of omentum to urachus or body wall

Question 12

Describe using a paracentesis to investigate umbilical swelling

Answer 12

Only if swollen abdomen and signs suggestive of peritonitis - total protein and cytology.

Question 13

Plasma total protein and Zinc sulphate or Sodium sulphite turbidity test are used for what reason?

Answer 13

To determine maternally derive antibody status

Question 14

Why perform a differential white cell count?

Answer 14

indicate active infection if animal has had time to mount a response

Question 15

Fibrinogen indicates?

Answer 15

Chronic inflammation

Question 16

When can you leave a hernia in a calf?

Answer 16

1 finger diameter and reducible

Question 17

How do you surgically approach a larger hernia

Answer 17

Butt together or “vest over pants”

Slowly absorbable; Vicryl braided, softest; PDS monofilament, may pull through

Question 18

How do you surgically approach a hernia too large so that you can’t draw the edges together?

Answer 18

Polypropylene (Prolene) mesh – scrupulous hygiene

Question 19

Describe post-op management following hernia surgery

Answer 19

MUST have minimum 1 month “box rest” and not turn out for 3 months after surgery to avoid breakdown.
Mix with smaller animals to avoid bullying

Question 20

Describe the steps of hernia surgery

Answer 20

• Anaesthesia GA best
• Elliptical incision or Flap over skin and do straight incisions either side to retain sufficient skin
• Dissect down edges of hernial ring using Metzenbum dissection scissors to free peritonium
• Hernial sac falls back into abdomen allowing edges of ring to be drawn together

Question 21

What are the agents that can cause umbilicus infection/abscesses outside the body wall

Answer 21

A. Pyogenes or E. Coli

Question 22

How do you treat an umbilicus infection/abscesses outside the body wall

Answer 22

Antibiotic (amoxicillin O.K.)
+/- open abscess cavity and flush with saline / disinfectants twice daily
Need several weeks treatment or reoccur