Page 1377 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

1352 CHAPTER 14

VetBooks.ir Clinical presentation the body wall if deeper structures are also involved.
There is often draining purulent material, which
The clinical presentation is variable, depending on
the severity of disease and whether disseminated
infection is present. Foals with involvement of the should be collected for culture and sensitivity testing.
Some foals may be pyrexic and inappetent. It is also
external remnants may develop significant enlarge- possible that signs of SIRS, sepsis or the sequelae (i.e.
ment of the umbilicus, which is often hot and painful septic arthritis, uveitis) present as the first clinical
on palpation. These abnormalities will extend into abnormality. Umbilical infections may act as a focus
of infection to seed other sites, and therefore a thor-
ough clinical examination should be carried out with
14.18
particular attention paid to localised signs of infec-
tion, such as septic arthritis/osteomyelitis. Infections
involving only the internal umbilical remnants can-
not be detected clinically and are identified during
diagnostic evaluation for a septic focus. Infection in
more than one umbilical vessel in the neonate is com-
mon, and urachal involvement is frequent.

Differential diagnosis
Umbilical rupture, haemorrhage or hernia; patent
urachus; ventral oedema or cellulitis.
Fig. 14.18 Transabdominal ultrasonogram of the
ventral abdomen of a foal showing a cross-section of the Diagnosis
umbilical region with marked omphalitis. Note the two Diagnosis is based on clinical signs and palpation and
normal umbilical arteries either side of a central enlarged confirmed on ultrasound examination. All foals with
and inflamed umbilicus. (Photo courtesy Massimo Magri)

14.19 14.20

Fig. 14.20 Transabdominal ultrasonogram of the
Fig. 14.19 Transabdominal ultrasonogram of the ventral ventral abdomen of a foal with unilateral omphaloarteritis,
abdomen of a foal with omphalophlebitis, or infection of or infection of one of the umbilical arteries, with
the umbilical vein, with an enlarged single vein filled by enlargement of the artery and increased luminal
hyperechoic material. (Photo courtesy Massimo Magri) hyperechoic material. (Photo courtesy Massimo Magri)