Bovis ISSN 2398-2993

Omphalophlebitis and omphaloarteritis

Synonym(s): Omphalitis, Inflammation of the umbilical structures

Contributor(s): Ben Dustan , Tim Potter

Introduction

  • Omphalitis is inflammation of the umbilical structures and may include the umbilical arteries, umbilical vein, urachus and/or tissues immediately surrounding the umbilicus.
    • Omphalophlebitis is inflammation and/or infection of the umbilical vein.
    • Omphaloarteritis is inflammation and/or infection of the umbilical arteries (both or singly).
  • Cause: acquired or congenital infection and/or trauma of umbilicus and associated structures.
  • Signs: enlarged umbilicus, possible purulent discharge, pain on palpation, systemically ill/septic calves.
  • Diagnosis: clinical examination and palpation, ultrasonography, bacteriology.
  • Treatment: antimicrobials and surgery.
  • Prognosis: dependent upon extent and severity of infection.
    • Localized infections in clinically well calves can carry a good prognosis.
    • Prognosis would be more guarded in systemically ill neonates.

Pathogenesis

Etiology

  • (Omphalo)-Arteritis is primarily an inflammatory reaction in the arterial wall, which often leads to endothelial damage and thrombosis.
    • There are two umbilical arteries that connect the internal iliac arteries to the placenta.
    • After birth these regress to become the round ligament of the bladder.
  • (Omphalo)-Phlebitis is inflammation of the vein and is frequently accompanied by thrombosis.
    • Neutrophilic leukocytes tend to dominate and, with chronicity, inflammatory fibrous tissue surrounds the vein.
    • There is one umbilical vein that connects the placenta to the liver and porta cava which regresses after birth to become the round ligament of the liver within the falciform ligament.
  • Both omphalophelbitis and omphaloarteritis develop secondary to acquired or congenital infection of the umbilical structures and/or trauma.
  • The conditions are frequently associated with poor hygiene in the calving environment and failure to pay attention to immediate post-calving umbilical care.
  • Omphalophlebitis may extend the length of the umbilical vein and result in hepatic abscessation.
  • Omphaloarteritis may extend to the bladder.
  • Omphalophlebitis is more common than omphaloarteritis in calves.

Predisposing factors

General

  • Poor hygiene of calving environment.
  • Dystocia/trauma at or during calving which can lead to inappropriate umbilical severance (too short, open, stretched, torn, over-zealous dam).
  • Poor post-calving management of umbilicus.
  • Failure of passive transfer.
  • Can occur as a result of navel sucking by other calves.

Timecourse

  • Neonatal – hours to days depending on severity of associated infection/development of sepsis.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Wieland M, Mann S, Guard C L & Nydam D V (2017) The influence of 3 different navel dips on calf health, growth performance, and umbilical infection assessed by clinical and ultrasonographic examination. J Dairy Sci 100 (1), 513-524 PubMed.
  • Marchionatti E, Nichols S, Babkine M, Fecteau G, Francoz D, Lard√© H & Desrochers A (2016) Surgical Management of Omphalophlebitis and Long Term Outcome in Calves: 39 Cases (2008-2013). Vet Surg 45 (2), 194-200 PubMed.
  • Steiner A & Lejeune B (2009) Ultrasonographic assessment of umbilical disorder. Vet Clin North Am Food Anim Pract 25, 78-794 PubMed.
  • Edwards R B & Fubini S L (1995) A one-stage marsupialization procedure for management of infected umbilical vein remnants in calves and foals. Vet Surg 24 (1), 32-5 PubMed.
  • Watson E, Mahaffey M B, Crowell W, Selcer B A, Morris D D & Seginak L (1994) Ultrasonography of the umbilical structures in clinically normal calves. Am J Vet Res 55, 773-780 PubMed.
  • Steiner A, Lischer C J & Oertle C (1993) Marsupialization of umbilical vein abscesses with involvement of the liver in 13 calves. Vet Surg 22 (3), 184-9 PubMed.

Other sources of information

  • Smith B P (2002) Manifestations of disease in the neonate. In: Large Animal Internal Medicine. 3rd edn. pp 369-370.
  • Radostitis O M, Gay C C, Blood D C & Hinchcliff (2000) Diseases of the newborn. In: Veterinary Medicine. 9th edn. pp 52.
  • Jones T C, Hunt R D & King N W (1997) Cardiovascular System. In: Veterinary Pathology. 6th edn. pp 1000-1004.


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