Umbilical & Urinary Disorders

Question 1

Omphalitis:

Answer 1

Inflammation of external or internal umbilicus

Question 2

Omphaloarteritis:

Answer 2

Inflammation of umbilical arterie(s)

Question 3

Omphalophlebitis:

Answer 3

Inflammation of umbilical vein

Question 4

Uroabdomen:

Answer 4

Leakage of urine into abdomen from ureters, bladder, or urachus

Question 5

Omphalitis signalment

Answer 5

Neonates 1-30 days old
Most prevalent <14 d

Question 6

Omphalitis pathophysiology:

Answer 6

Improper cord separation
Inflammation- improper application of iodine etc
Infectious- most common

Question 7

Omphalitis clinical signs:

Answer 7

Frequent attempts to urinate/Straining
Urine dribbling from umbilicus
Swollen, painful umbilicus
Purulent material
Fever

Question 8

CBC Findings with omphalitis:

Answer 8

Leukocytosis or leukopenia, hyperfibrinogenemia

Question 9

Complications associated with Omphalitis:

Answer 9

Sepiticemia, Septic Joints, Osteomyelitis, Peritonitis, Pneumonia, Meningitis

Question 10

Omphalitis Tx:

Answer 10

Medical- antimicrobials appropriate if mild
Surgical

Question 11

Poor prognostic indicators after omphalitis sx treatment

Answer 11

Can’t resect entire infection
Umbilical vein infected
Sepsis +/- Synovial structure infection

Question 12

Cause of umbilical hernias:

Answer 12

Congenital

Question 13

Treatment options of umbilical hernias:

Answer 13

Conservative- easily reduced, often spontaneously regresses
Surgery- Not reducible (Strangulation = EMERGENT)
or failure to resolve

Question 14

Signalment of Patent Urachus:

Answer 14

Neonate foals, calves, & small ruminants

Question 15

Normal closure of the urachus:

Answer 15

Within hours of birth

Question 16

Etiologies of Patent Urachus:

Answer 16

Congenital- failure to close (physics of it all)
Acquired- Closes then reopens (Inflammation, Infection, Increased Abdominal pressure- constipation, lifted)

Question 17

Most common urinary malformation in foals:

Answer 17

Patent urachus

Question 18

Tx options for patent urachus:

Answer 18

Medical- catheter, chlorhex dip, cautery
Should close within a few days
Sx- Umbilical resection (duration >3days)

**NEED TO MONITOR FOR SIGNS OF SEPSIS- monitor TPR & palpate joints

Question 19

Signalment of uroperitoneum

Answer 19

Colts&raquo_space;> Fillies
Bladder rupture during parturition

Question 20

Etiologies of Uroperitoneum

Answer 20

Ruptured bladder- parturition/lifting, congenital malformations
Rupture of urachus- omphalitis

Question 21

Clinical Signs of Uroperitoneum:

Answer 21

Born normal, crashes after 48-72 hr
Lethargy, Anorexia, Abd distension, stranguria, intermittent colic

Question 22

Classic changes associated with uroperitoneum:

Answer 22

Hyponatremia, Hypochloremia, Hyperkalemia, Azotemia,
=>
Muscle Tremors, Neuro deficits, Cardiac abnormalities

Question 23

Dx of Uroperitoneum:

Answer 23

Ultrasound
Abdominocentesis- Abdominal Creatinine/Serum creatinine ≥ 2

Question 24

Why is uroperitoneum an emergency?

Answer 24

Hyperkalemia** Fix before anesthesia
Decreased lung capacity
Distended abdomen
Hypoxemia

Question 25

Potassium goals prior to uroabdomen surgery:

Answer 25

K+ <5.5 mEq/L

Question 26

Tx of Uroabdomen:

Answer 26

Correct Hyperkalemia Slow Peritoneal Drainage Calcium Sx- urachal remnant resection, Cystorrhapathy (Bladder repair) & abdominal lavage